Individual
MR. MICHAEL J MACEJKO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C
Contact information
Practice address
1601 W 23RD ST, HAZLETON, PA 18202-1646
(570) 459-3221
(570) 459-3139
Mailing address
1525 TERRACE BLVD, HAZLETON, PA 18201-7527
(570) 455-0921
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT000213A
PA
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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