Individual
KIRA LYNN MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
801 BRAXTON PL, MADISON, WI 53715-1415
(608) 260-2700
Mailing address
731 WILLIAMSON ST APT 341, MADISON, WI 53703-3545
(262) 903-8541
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16980-24
WI
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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