Individual
MICHAEL JOHN METCALFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CSCS, CES
Contact information
Practice address
239 PARK AVE, PORTLAND, ME 04102-2911
(651) 285-2478
Mailing address
550 FOREST AVE STE 102, PORTLAND, ME 04101-1505
(651) 285-2478
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1911
MN
2255A2300X
Athletic Trainer
Primary
AT678
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT678
ATHLETIC TRAINING LICENSE
ME
Enumeration date
02/17/2010
Last updated
03/17/2018
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