Provider Demographics
NPI:1023072311
Name:PIPER, JOHN GLYN (ATC, CSCS)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:GLYN
Last Name:PIPER
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
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Mailing Address - Street 1:3031 MOSHERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250
Mailing Address - Country:US
Mailing Address - Phone:269-352-7645
Mailing Address - Fax:517-841-7496
Practice Address - Street 1:1 S JACKSON SQ
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2240
Practice Address - Country:US
Practice Address - Phone:517-841-7497
Practice Address - Fax:517-841-7496
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer