Individual
MICHAEL JOHN CHESTERFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
840 WOOD ST, CLARION, PA 16214-1240
(814) 393-2006
(814) 393-1735
Mailing address
840 WOOD ST, CLARION, PA 16214-1240
(814) 393-2006
(814) 393-1735
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004383
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RT004383
COMMONWEALTH OF PA DEPT OF STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIR
PA
Enumeration date
12/08/2014
Last updated
12/08/2014
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