Provider Demographics
NPI:1356441299
Name:STRAUCH, MICHELLE JOAN (ATC)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:JOAN
Last Name:STRAUCH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:MISSY
Other - Middle Name:
Other - Last Name:STRAUCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4217 40TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2270
Mailing Address - Country:US
Mailing Address - Phone:651-261-1465
Mailing Address - Fax:
Practice Address - Street 1:2211 RIVERSIDE AVE
Practice Address - Street 2:CAMPUS BOX 313
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1350
Practice Address - Country:US
Practice Address - Phone:612-330-1310
Practice Address - Fax:612-330-1372
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer