Provider Demographics
NPI:1750407185
Name:MICHAELS, JAMES A
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:MICHAELS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 TENNIS DR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3378
Mailing Address - Country:US
Mailing Address - Phone:508-845-3500
Mailing Address - Fax:508-845-7772
Practice Address - Street 1:3 TENNIS DR
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-3378
Practice Address - Country:US
Practice Address - Phone:508-845-3500
Practice Address - Fax:508-845-7772
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist