IndividualActive
Alisia Macioch, M.S., LAT, ATC
NPI 1568998482 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Roseville, MN
Provider details
- NPI number
- 1568998482
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.S., LAT, ATC
- Sex
- Female
- Sole proprietor
- Yes
- License
- 3138 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
1240 County Road B2 W
Roseville, MN 55113-4338
Phone: (651) 301-2279
Approximate (ZIP-level) locationGet directions
Mailing address
320 6th Ave S
South Saint Paul, MN 55075-2624
Registry dates
- Enumerated
- 2017-05-11
- Last updated
- 2026-03-05
- Certified
- 2026-03-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.