Individual
MRS. MIKYUNG MIKEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2170 HARPOON DR, STAFFORD, VA 22554-2330
(540) 720-7688
Mailing address
2170 HARPOON DR, STAFFORD, VA 22554-2330
(540) 720-7688
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
—
—
Other
Enumeration date
04/16/2011
Last updated
04/16/2011
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