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Individual

MR. MICHAEL J KICERA JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1821 S STOUGHTON RD, DEAN MEDICAL CENTER, MADISON, WI 53716-2257
(608) 260-6905
(608) 260-6906
Mailing address
1821 S STOUGHTON RD, DEAN MEDICAL CENTER, MADISON, WI 53716-2257
(608) 260-6905
(608) 260-6906

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6347-024
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1164609632
WI
Enumeration date
01/28/2008
Last updated
12/27/2020
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