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General NPI Number Information
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NPI Number | 1639214380
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Entity Type | Individual
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Provider Name | MICHAEL L. ALVES ATC, CSCS
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Gender | Male
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1359 WASHINGTON ST BOSTON SPORTS CLUBS
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City | WEST NEWTON
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State | MA
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Zip | 02465-2004
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Country | US
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Telephone | 617-332-1700
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Fax | 617-332-1719
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Provider Business Mailing Address
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Address Line | 12 VICTORIA ST UNIT 2
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City | DORCHESTER
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State | MA
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Zip | 02125-1813
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Country | US
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Telephone | 413-218-6607
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Fax | 617-287-0921
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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 | 1233
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License Number State | MA
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