Individual
RICHARD MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
1501 E PARKS HWY, WASILLA, AK 99654-8283
(907) 352-5033
(907) 352-5027
Mailing address
1501 E PARKS HWY, WASILLA, AK 99654-8283
(907) 352-5033
(907) 352-5027
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1644
AK
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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