Individual
TAYLOR MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5140 GATE PKWY, 2104, JACKSONVILLE, FL 32256-0232
(501) 282-4145
Mailing address
5140 GATE PKWY, 2104, JACKSONVILLE, FL 32256-0232
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 4197
FL
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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