Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Divine Mathes

Individual provider Athletic Trainer · NPI 1558071829

Divine Mathes is an Athletic Trainer in Detroit, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2022

Practice location Address checks out

5101 John C Lodge Fwy
Detroit, MI 48202-3327
Phone: (313) 577-4280
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2601002776 (MI)

Record details

NPI number1558071829
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 28, 2022
Last updated in NPPESNovember 28, 2022
Certification dateNovember 28, 2022
Mailing address23010 Hayes Ave, Eastpointe, MI 48021-1541

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