Provider Demographics
NPI:1871628842
Name:WARD, MICHELLE DAWN (ATC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:DAWN
Last Name:WARD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:DAWN
Other - Last Name:ZAHRT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:3304 SILVER BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-5102
Mailing Address - Country:US
Mailing Address - Phone:231-773-2765
Mailing Address - Fax:
Practice Address - Street 1:1675 LEAHY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5500
Practice Address - Country:US
Practice Address - Phone:231-728-4820
Practice Address - Fax:231-728-4041
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer