Individual
DR. KEVIN RUSSELL MIKALAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1318 VIVIAN ST, LONGMONT, CO 80501-3217
(303) 776-0882
(303) 776-1053
Mailing address
1318 VIVIAN ST, LONGMONT, CO 80501-3217
(303) 776-0882
(303) 776-1053
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHR-6064
CO
Other
Enumeration date
11/27/2007
Last updated
01/07/2008
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