Individual
DR. CHRISTINE M MIKOLAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
129 N CHALKVILLE RD, TRUSSVILLE, AL 35173-1376
(205) 661-2080
(205) 661-2085
Mailing address
PO BOX 1310, TRUSSVILLE, AL 35173-6102
(205) 661-2080
(205) 661-2085
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
R-182-TA-821
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113066
—
AL
01
—
R-182-TA-821
ALABAMA OPTOMETRY LICENSE
AL
Enumeration date
08/04/2008
Last updated
03/07/2023
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