Provider Demographics
NPI:1295195816
Name:CHAPMAN, MICHAEL (ATC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 BOMAN ROAD
Mailing Address - Street 2:
Mailing Address - City:ALGER
Mailing Address - State:MI
Mailing Address - Zip Code:48610
Mailing Address - Country:US
Mailing Address - Phone:248-974-3891
Mailing Address - Fax:
Practice Address - Street 1:1515 BOMAN ROAD
Practice Address - Street 2:
Practice Address - City:ALGER
Practice Address - State:MI
Practice Address - Zip Code:48610
Practice Address - Country:US
Practice Address - Phone:248-974-3891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21842255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer