Provider Demographics
NPI:1750182341
Name:MAHER, JOHN (ATC,LAT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MAHER
Suffix:
Gender:
Credentials:ATC,LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 ROYAL CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-9565
Mailing Address - Country:US
Mailing Address - Phone:517-290-7278
Mailing Address - Fax:
Practice Address - Street 1:1555 ROYAL CRESCENT DR
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-9565
Practice Address - Country:US
Practice Address - Phone:517-290-7278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer