Individual
MR. MARK MIKKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
230 WATERFORD PKWY S, WATERFORD, CT 06385-1219
(860) 271-4360
Mailing address
230 WATERFORD PKWY S, WATERFORD, CT 06385-1219
(860) 271-4630
Taxonomy
Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
Primary
5784
CT
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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