Individual
MICHAEL JOSEPEH NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2532 SIMS AVE, SAINT LOUIS, MO 63114-3204
(314) 882-7665
Mailing address
209 S KINGSHIGHWAY ST, SAINT CHARLES, MO 63301-1695
(636) 339-6951
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2011026856
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000000863
NATABOC
—
01
—
2011026856
DIVISION OF PROFRESSIONAL REGULATION
MO
Enumeration date
02/01/2010
Last updated
12/13/2023
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