# PREMIER PHYSICAL HEALTHCARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811267214
- **Authorized official:** JOHN RYAN MICHAELS (OWNER)
- **Authorized official phone:** (218) 262-3315

## Contact information

- **Practice address:** 115 W HOWARD ST, HIBBING, MN 55746-1548
- **Practice address phone:** (218) 262-3315
- **Practice address fax:** (218) 263-9648
- **Mailing address:** 115 W HOWARD ST, HIBBING, MN 55746-1548
- **Mailing address phone:** (218) 262-3315
- **Mailing address fax:** (218) 263-9648

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | 29671 | MN | Yes |

## Other

- **Enumeration date:** 01/03/2012
- **Last updated:** 10/31/2012