Individual
MR. MICHAEL STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
8227 NORTHWEST BLVD, SUITE 160, INDIANAPOLIS, IN 46278-1387
(317) 415-5795
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
34001968A
IN
Other
Enumeration date
11/02/2011
Last updated
10/02/2014
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