Individual provider · NPI-1

Michelle Denise St Clair, Health Care Provider

Specialist/Technologist, Athletic Trainer · Lithonia, GA

NPI number1124466750
StatusActive
Last updated in NPPESJun 28, 2013

Details

NPI
1124466750
Entity type
Individual (NPI-1)
Name
Ms. Michelle Denise St Clair
Credential
Health Care Provider
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 5, 2013
Last updated
Jun 28, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer052440720GAYes

Practice location

841 Plumbridge Ct
Lithonia, GA 30058-9020

Phone 678-677-1225

Mailing address

841 Plumbridge Ct
Lithonia, GA 30058-9020

Phone 678-677-1225

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