Provider Demographics
NPI:1922649326
Name:ALTRICH, MICHELLE (PHD HCLD (ABB))
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ALTRICH
Suffix:
Gender:F
Credentials:PHD HCLD (ABB)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18000 W 99TH ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1233
Mailing Address - Country:US
Mailing Address - Phone:800-305-5198
Mailing Address - Fax:
Practice Address - Street 1:18000 W 99TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1233
Practice Address - Country:US
Practice Address - Phone:800-305-5198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician