Individual
MIKAL JOSEPH MIKKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1101 MOULTON AND PARSONS DR, SAINT JAMES, MN 56081-5550
(507) 375-3391
Mailing address
1101 MOULTON AND PARSONS DR, SAINT JAMES, MN 56081-5550
(507) 375-3391
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1841
MN
363A00000X
Physician Assistant
Primary
10977
MN
Other
Enumeration date
10/18/2006
Last updated
09/17/2020
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