Provider Demographics
NPI:1841785623
Name:DION, MICHAEL STEPHEN (MS, ATC, LAT, PES)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STEPHEN
Last Name:DION
Suffix:
Gender:M
Credentials:MS, ATC, LAT, PES
Other - Prefix:
Other - First Name:MICAH
Other - Middle Name:STEPHEN
Other - Last Name:DION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, ATC, LAT, PES
Mailing Address - Street 1:153 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-1423
Practice Address - Country:US
Practice Address - Phone:413-538-3698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2929204C00000X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine