Individual
MR. MICHAEL STATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
3200 S WATER ST, PITTSBURGH, PA 15203-2307
(412) 867-9079
Mailing address
3200 S WATER ST, PITTSBURGH, PA 15203-2307
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004150
PA
Other
Enumeration date
04/19/2014
Last updated
04/19/2014
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