Elizabeth Marie Henk, MS, AT, ATC

Individual provider Active NPI Athletic Trainer · Mattawan, MI

NPI 1457749640 · NPPES record last updated Dec 23, 2014

Key facts

NPI
1457749640
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2601000230 (MI)
Practice address
4090 60TH Ave
Mattawan, MI 49071-9525
Phone
(269) 377-7884
NPI assigned
Dec 23, 2014
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2601000230MIMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2601000230 MI Yes

Addresses

Primary practice location

4090 60TH Ave
Mattawan, MI 49071-9525

Mailing address

24090 60TH Ave
Mattawan, MI 49071-9525
Phone (269) 377-7884

Other providers in Mattawan, MI

All providers in Mattawan, MI · Athletic Trainer in Michigan

Sources for this page

Verify at the official NPI Registry.