Individual
EVAN JAMES MICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2403 N STOCKTON HILL RD STE 4AND5, KINGMAN, AZ 86401-4188
(928) 529-5311
(928) 529-5313
Mailing address
2085 ARROYO VISTA LN, KINGMAN, AZ 86401-8770
(928) 530-8395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-010285
AZ
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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