Individual
MIKAL KIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1251
(319) 398-6011
Mailing address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1292
(319) 398-6011
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
093672
IA
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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