Individual
MR. MICHAEL THOMAS MEDICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
146 GALLOWAY RD, GALLOWAY, OH 43119-9402
(614) 581-7082
(614) 870-5531
Mailing address
8571 BIVOUAC PL, GALLOWAY, OH 43119-8445
(614) 878-7609
(614) 870-5531
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT103
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT103
ATHLETIC TRAINER
OH
Enumeration date
07/03/2006
Last updated
07/08/2007
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