Individual
HOLLY MICKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3030 NW EXPRESSWAY STE 809, OKLAHOMA CITY, OK 73112-5466
(405) 917-7160
(405) 917-7161
Mailing address
708 COYOTE CT, YUKON, OK 73099-6863
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1916
OK
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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