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Individual

MR. MICHAEL JOHN SCANDIN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PT LAT

Contact information

Practice address
16 E MENARD PLAZA, WAUSAU, WI 54401
(715) 845-2942
(715) 842-3416
Mailing address
PO BOX 1349, SPORT & SPINE CLINIC, WAUSAU, WI 54402-1349
(715) 845-2942
(715) 842-3416

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
3841024
WI
2255A2300X
Athletic Trainer
Primary
540039
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29129
SECURITY HEALTH
WI
05
4180500
WI
Enumeration date
05/11/2006
Last updated
09/11/2025
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