Provider Demographics
NPI:1841268372
Name:BRAID, MICHAEL J (ATC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:BRAID
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:18000 COVE STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-1383
Mailing Address - Country:US
Mailing Address - Phone:616-847-1280
Mailing Address - Fax:616-847-1290
Practice Address - Street 1:18000 COVE STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-1383
Practice Address - Country:US
Practice Address - Phone:616-847-1280
Practice Address - Fax:616-847-1290
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2014-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI26010002002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer