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Individual

MR. BARRY SCOTT MICHAELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
8051 PALOMAS AVE NE, ALBUQUERQUE, NM 87109-5284
(410) 486-0275
(410) 486-0276
Mailing address
1309 PINE RIDGE LN, PIKESVILLE, MD 21208-3731
(410) 486-0275
(410) 486-0276

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4367
NM
2251E1200X
Ergonomics Physical Therapist
17822
MD
2251G0304X
Geriatric Physical Therapist
17822
MD
2251X0800X
Orthopedic Physical Therapist
17822
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
143300800
MD
Enumeration date
07/11/2005
Last updated
06/10/2021
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