Individual
MELISSA M MIKUSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
718 JUPITER DR, MADISON, WI 53718-2950
(608) 663-8600
Mailing address
4219 OWL CREEK DR, MADISON, WI 53718-4409
(860) 459-9991
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
12206-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12206-24
PHYSICAL THERAPIST
WI
Enumeration date
02/01/2018
Last updated
02/01/2018
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