Provider Demographics
NPI:1841052131
Name:HARTMAN, MICHAEL (MS, LAT, ATC, CES)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:MS, LAT, ATC, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2957 LOCUST GROVE CT APT 2
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3980
Mailing Address - Country:US
Mailing Address - Phone:319-321-3155
Mailing Address - Fax:
Practice Address - Street 1:2957 LOCUST GROVE CT APT 2
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-3980
Practice Address - Country:US
Practice Address - Phone:319-321-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer