Individual
ADAM MIKKELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
316 BROADWAY ST, AUDUBON, IA 50025-1104
(712) 563-2655
Mailing address
316 BROADWAY ST, AUDUBON, IA 50025-1104
(712) 563-2655
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22284
IA
Other
Enumeration date
04/03/2018
Last updated
04/03/2018
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