Individual
MR. MICHAEL BACKUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSM, ATC, PA-C
Contact information
Practice address
1224 TROTWOOD AVE, COLUMBIA, TN 38401-4802
(931) 381-1111
Mailing address
1224 TROTWOOD AVE, COLUMBIA, TN 38401-4802
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
627
TN
363A00000X
Physician Assistant
Primary
2267
TN
Other
Enumeration date
11/23/2005
Last updated
01/09/2020
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