Individual
MR. MICHAEL VINCENT BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
100 ALMSHOUSE RD, RICHBORO, PA 18954-1108
(215) 357-2000
Mailing address
920 MONARCH CT, CHALFONT, PA 18914-2057
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000121
PA
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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