Individual
MICHAEL MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5535 S WILLIAMSON BLVD, 774, PORT ORANGE, FL 32128-8311
(800) 330-7711
(866) 426-2811
Mailing address
54530 COUNTY ROAD 1, ELKHART, IN 46514-8961
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004145A
IN
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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