Individual
MICHAELYN MICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LRT
Contact information
Practice address
2265 S 9TH ST, SALINA, KS 67401-7308
(785) 452-6002
Mailing address
508 N STARK ST, BENNINGTON, KS 67422-9429
(785) 416-0033
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2205923
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2205923
ARRT
KS
Enumeration date
06/02/2020
Last updated
06/02/2020
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