Provider Demographics
NPI:1255872131
Name:MICHALSKI, MICHAEL JR (MHSA, LAT, ATC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MICHALSKI
Suffix:JR
Gender:M
Credentials:MHSA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 MANCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1919
Mailing Address - Country:US
Mailing Address - Phone:586-747-6637
Mailing Address - Fax:
Practice Address - Street 1:1664 N. VIRGINIA ST.
Practice Address - Street 2:MAIL STOP 265
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-9401
Practice Address - Country:US
Practice Address - Phone:775-784-4070
Practice Address - Fax:775-784-8077
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program