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Organization
CHILDREN'S SPORTS MEDICINE FOUNDATION
Active
Organization
CHILDREN'S SPORTS MEDICINE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYLE J MICHELI M.D. (DIRECTOR)
(617) 355-5971
Entity
Organization
Contact information
Practice address
319 LONGWOOD AVE, BOSTON, MA 02115-5728
(617) 355-5971
(617) 730-0178
Mailing address
PO BOX 3694, BOSTON, MA 02241-3694
(508) 946-1665
(508) 947-1293
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
Primary
—
NULL
213ES0000X
Sports Medicine Podiatrist
Primary
—
—
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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