Individual
MICHAEL T PACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
120 W DUBLIN DR, SUITE 202, MADISON, AL 35758-3107
(228) 326-1032
Mailing address
261 WEDGEWOOD TERRACE RD, MADISON, AL 35757-8911
(228) 326-1032
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2580
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2580
STATE LICENSE NUMBER
AL
Enumeration date
01/25/2007
Last updated
07/08/2007
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