Individual
MICHAEL EDISON POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-8703
(903) 877-8707
Mailing address
912 W NOBLE ST, TROUP, TX 75789-1702
(903) 843-1948
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2076407
TX
Other
Enumeration date
06/03/2010
Last updated
01/09/2013
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