Mandy Mickelson PTA

NPI 1659548063 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1659548063
Gender Female
Enumeration Date 05/14/2008
Last Updated 05/14/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
2501 SHELBY RD
LA CROSSE WI, 54601-8037, US
Phone (608) 788-5700
Fax
Business Location
6232 STATE HIGHWAY 16
SPARTA WI, 54656-3505, US
Phone (608) 343-1236
Fax
Toxanomy
Taxonomy Code 225200000X
License State Wisconsin
License Number 1409-019
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According to our database, Mandy Mickelson PTA NPI is 1659548063, taxonomy code is 225200000X and license number is 1409-019, license state is located at Wisconsin. Mandy Mickelson PTA physically located at 2501 Shelby Rd, La Crosse WI, 54601-8037. NPI Number Mandy Mickelson PTA has the Individual type.

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1659548063 NPI number is provided on an as is basis without warranty of any kind. 1659548063 is maintained by the National Plan & Provider Enumeration System. The contents of Mandy Mickelson PTA are for informational purposes only.