Individual
MRS. MARY MICKELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5505 GROVER ST, OMAHA, NE 68106-3718
(402) 551-4970
(402) 558-0227
Mailing address
5505 GROVER ST, OMAHA, NE 68106-3718
(402) 551-4970
(402) 558-0227
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2496
NE
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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