Individual
KAITLYN MARIE MIKALIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, MPH, PA-C
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-4000
Mailing address
2075 BROOKSHIRE RD, FURLONG, PA 18925-1274
(215) 622-1088
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA065722
PA
363A00000X
Physician Assistant
Primary
OA006909
PA
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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