Individual
MICHAEL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1 COLLEGE ST, WORCESTER, MA 01610-2395
(508) 793-2903
Mailing address
1 COLLEGE ST, WORCESTER, MA 01610-2395
(508) 793-2903
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2680
MA
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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