Individual
MS. DOLLIA MARIE MICKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
102 CLARENDON DR APT 303, NOBLESVILLE, IN 46062
(317) 385-1343
Mailing address
102 CLARENDON DR APT 303, NOBLESVILLE, IN 46062
(317) 385-1343
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002811A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06002811A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
12/06/2012
Last updated
12/06/2012
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