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General NPI Number Information
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NPI Number | 1992848337
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Entity Type | Individual
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Provider Name | JEREMY DANIEL ATKINS ATC
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1600 E OAKLEY PARK RD
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City | COMMERCE TOWNSHIP
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State | MI
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Zip | 48390-5509
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Country | US
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Telephone | 248-672-0106
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Fax |
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Provider Business Mailing Address
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Address Line | 12853 DIXIE
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City | REDFORD
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State | MI
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Zip | 48239-2601
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Country | US
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Telephone | 248-763-1432
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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