Provider Demographics
NPI:1356476097
Name:MICHEL, ELIZABETH RENEE (ATC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:RENEE
Last Name:MICHEL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5250 N BRAWLEY AVE
Mailing Address - Street 2:#210
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6604
Mailing Address - Country:US
Mailing Address - Phone:559-213-9402
Mailing Address - Fax:
Practice Address - Street 1:1406 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-3789
Practice Address - Country:US
Practice Address - Phone:559-268-9251
Practice Address - Fax:559-268-1351
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer