Individual
MR. ANDRE JAMES MICKAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, M.ED
Contact information
Practice address
515 W MAYFIELD RD STE 116, ARLINGTON, TX 76014-2084
(972) 623-2629
Mailing address
515 W MAYFIELD RD STE 116, ARLINGTON, TX 76014-2084
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2967
TX
Other
Enumeration date
02/16/2010
Last updated
02/16/2010
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