Provider Demographics
NPI:1871587675
Name:HIGGINS, MICHAEL (ATC, PT, CSCS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:ATC, PT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 KILLDEER LN
Mailing Address - Street 2:
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932-2832
Mailing Address - Country:US
Mailing Address - Phone:443-848-3317
Mailing Address - Fax:410-704-3912
Practice Address - Street 1:210 EMMET ST S
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-2455
Practice Address - Country:US
Practice Address - Phone:434-924-7907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23050037982251S0007X
MD164182251S0007X
DE10162251S0007X
DEJ300001042255A2300X
VA01260027112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports