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Contact Information

ALISIA K MACIOCH, M.S., LAT, ATC
1240 COUNTY ROAD B2 W
ROSEVILLE, MN55113-4338
 Phone: 651-301-2279
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for ALISIA K MACIOCH · (Female)

NPI # 1568998482
Status Active
Credentials M.S., LAT, ATC
Entity Individual
Enumeration date 05/11/2017
Last updated 03/05/2026 - About 3 months ago
Sole proprietor 1 Yes
Identifiers
  • MN License # 3138
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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