Provider Demographics
NPI:1306723549
Name:CIESIELSKI, CAMERON J (ATC)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:J
Last Name:CIESIELSKI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 S FRANKLIN ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3128
Mailing Address - Country:US
Mailing Address - Phone:989-414-7899
Mailing Address - Fax:
Practice Address - Street 1:1155 S ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-3221
Practice Address - Country:US
Practice Address - Phone:989-775-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer