Individual
MICHAEL XINYU MIAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1 MARKET STREET, 3RD FLOOR, LYNN, MA 01901
(781) 592-0540
Mailing address
120 SELWYN RD, NEWTON, MA 02461-2143
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9224
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9224
PTA
MA
Enumeration date
07/18/2017
Last updated
06/16/2018
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