Provider Demographics
NPI:1477804870
Name:ROOT, MICHAEL S (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:ROOT
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:90 SOUTHSIDE AVE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:19406-3722
Mailing Address - Country:US
Mailing Address - Phone:828-254-3525
Mailing Address - Fax:828-254-0792
Practice Address - Street 1:90 SOUTHSIDE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4160
Practice Address - Country:US
Practice Address - Phone:828-254-3525
Practice Address - Fax:828-254-0792
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2015-08-31
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Provider Licenses
StateLicense IDTaxonomies
NCP15635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC561786885Medicare UPIN