Individual
RYAN AUSTIN MICHAELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, CAT
Contact information
Practice address
99 MARKET CENTER DR, COLLIERVILLE, TN 38017-6913
(901) 861-9610
Mailing address
1862 SWYNFORD LN, COLLIERVILLE, TN 38017-8874
(901) 647-3016
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3111
TN
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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