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Individual

JAMES MIKRUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
919 12TH PL STE 11, PRESCOTT, AZ 86305-1433
(928) 632-0800
(928) 632-8505
Mailing address
13175 E HIGHWAY 169, DEWEY, AZ 86327-7372
(928) 632-0800
(928) 632-8505

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501005426
MI
225100000X
Physical Therapist
Primary
6486
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
915936
AZ
Enumeration date
05/19/2006
Last updated
07/25/2024
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