Organization
MIKKELSEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LINCOLN MIKKELSEN (MANAGER)
(616) 723-5020
Entity
Organization
Contact information
Practice address
4200 SOUTH FWY, SUITE 615, FORT WORTH, TX 76115-1400
(817) 210-4778
Mailing address
4200 SOUTH FWY, SUITE 615, FORT WORTH, TX 76115-1400
(817) 210-4778
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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