Provider Demographics
NPI:1285823286
Name:DART, MICHAEL F (MS, AT,C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:F
Last Name:DART
Suffix:
Gender:M
Credentials:MS, AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99114-2903
Mailing Address - Country:US
Mailing Address - Phone:509-684-5027
Mailing Address - Fax:509-684-6133
Practice Address - Street 1:217 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-2903
Practice Address - Country:US
Practice Address - Phone:509-684-5027
Practice Address - Fax:509-684-6133
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer