Vince Mottes

Individual provider Active NPI Athletic Trainer · Grass Lake, MI

NPI 1033640248 · NPPES record last updated Mar 21, 2017

Key facts

NPI
1033640248
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2601001510 (MI)
Practice address
9550 Cedar Knoll Dr
Grass Lake, MI 49240-9634
Phone
(517) 315-1150
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2601001510MIMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2601001510 MI Yes

Addresses

Primary practice location

9550 Cedar Knoll Dr
Grass Lake, MI 49240-9634

Mailing address

9550 Cedar Knoll Dr
Grass Lake, MI 49240-9634
Phone (517) 315-1150

Other providers in Grass Lake, MI

All providers in Grass Lake, MI · Athletic Trainer in Michigan

Sources for this page

Verify at the official NPI Registry.