Provider Demographics
NPI:1689717811
Name:POIRIER, MICHAEL PATRICK (MA, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PATRICK
Last Name:POIRIER
Suffix:
Gender:M
Credentials:MA, ATC, CSCS
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Other - Middle Name:
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Mailing Address - Street 1:1279 103RD AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-1912
Mailing Address - Country:US
Mailing Address - Phone:269-685-5614
Mailing Address - Fax:269-685-0893
Practice Address - Street 1:411 NAOMI ST
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1222
Practice Address - Country:US
Practice Address - Phone:269-685-0781
Practice Address - Fax:269-685-0893
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer