Individual
MIKKALA ELIZABETH WHITED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 CHERRY ST, JOHNSON CITY, NY 13790-2615
(607) 723-8313
Mailing address
24 CHERRY ST, JOHNSON CITY, NY 13790-2615
(607) 238-6906
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
10/07/2022
Last updated
12/18/2024
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