Individual
MICHAEL A MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
7423 S MASON MONTGOMERY RD, MASON, OH 45040-7828
(513) 347-9999
(513) 573-9178
Mailing address
7423 S MASON MONTGOMERY RD, MASON, OH 45040-7828
(513) 347-9999
(513) 573-9178
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
PT002212
KY
2251X0800X
Orthopedic Physical Therapist
Primary
PT06009
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2526350
—
OH
05
—
8700152500
—
KY
Enumeration date
06/17/2005
Last updated
01/24/2014
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