Individual
MICHAELA MARIE MAHAFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
514 17TH ST W, CLEAR LAKE, IA 50428-1205
(706) 564-3558
Mailing address
514 17TH ST W, CLEAR LAKE, IA 50428-1205
(706) 564-3558
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
092077
IA
225200000X
Physical Therapy Assistant
A2377
MN
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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