Provider First Line Business Practice Location Address:
131 DUFFY DAUGHERTY FOOTBALL BUILDING
Provider Second Line Business Practice Location Address:
MICHIGAN STATE ATHLETIC TRAINING
Provider Business Practice Location Address City Name:
EAST LANSING
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-353-1655
Provider Business Practice Location Address Fax Number:
517-432-2137
Provider Enumeration Date:
03/16/2009