Individual
MR. MICHAEL JAMES FEDYSHIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
534 E PLEASANT ST, CORRY, PA 16407-2246
(814) 665-8297
Mailing address
22633 PHILLIPS DR, PLEASANTVILLE, PA 16341-9658
(814) 589-7363
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT000421A
PA
Other
Enumeration date
03/21/2006
Last updated
07/08/2007
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