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Individual
MICHAEL G MASSENBURG
Active
Individual
MICHAEL G MASSENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1186858
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
812T75
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
01/22/2009
Last updated
03/16/2009
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