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General NPI Number Information
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NPI Number | 1093257370
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Entity Type | Individual
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Provider Name | MICHAEL PLAISANCE ATC
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Gender | Male
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Dates
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Enumeration Date | 11/17/2016
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 1182 TROY SCHENECTADY RD
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City | LATHAM
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State | NY
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Zip | 12110-1001
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Country | US
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Telephone | 518-713-5400
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Fax | 518-713-5401
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Provider Business Mailing Address
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Address Line | 1540 TIBBITS AVE
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City | TROY
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State | NY
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Zip | 12180-3632
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Country | US
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Telephone | 802-733-8837
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 003863
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License Number State | NY
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