Provider Demographics
NPI:1578840609
Name:COLVIN, MICHELLE RENEE (MA, ATC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:RENEE
Last Name:COLVIN
Suffix:
Gender:F
Credentials:MA, ATC
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:RENEE
Other - Last Name:TRUMBULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, ATC
Mailing Address - Street 1:7595 COUNTY ROAD 236
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-8738
Mailing Address - Country:US
Mailing Address - Phone:419-427-1984
Mailing Address - Fax:419-427-2326
Practice Address - Street 1:7595 COUNTY ROAD 236
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-8738
Practice Address - Country:US
Practice Address - Phone:419-427-1984
Practice Address - Fax:419-427-2326
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0035972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer