Individual
MICHAEL J PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1903 W MICHIGAN AVE, KALAMAZOO, MI 49008-5201
(517) 648-4496
Mailing address
2830 ARCTIC AVE, KALAMAZOO, MI 49004-2153
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001516
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2601001516
STATE OF MICHIGAN LARA
MI
Enumeration date
12/01/2020
Last updated
12/01/2020
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