Individual
DR. MICHAEL EDWARD PADDACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, PTA, CPT
Contact information
Practice address
1011 ROCKFELLOW DR, MOUNT SHASTA, CA 96067-9404
(530) 926-2599
Mailing address
1011 ROCKFELLOW DR, MOUNT SHASTA, CA 96067-9404
(530) 926-2599
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT4271
CA
2255A2300X
Athletic Trainer
—
CA
Other
Enumeration date
02/20/2013
Last updated
02/20/2013
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