Individual
DR. TJODE M MICKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C
Contact information
Practice address
105 BORGA BUILDING, FESTUS, MO 63028-1136
(636) 937-3207
(636) 937-5307
Mailing address
8914 KATHLYN DR, SAINT LOUIS, MO 63134-3552
(314) 398-5800
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2005036767
MO
Other
Enumeration date
11/14/2005
Last updated
07/08/2007
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