Individual
MICHAEL KITTOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11475 ROBINSON DR NW, COON RAPIDS, MN 55433-7432
(763) 587-9000
Mailing address
11475 ROBINSON DR NW, COON RAPIDS, MN 55433-7432
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13578
MN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/19/2019
Last updated
12/22/2022
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