Individual
MRS. MICKAELA JILL RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,DPT
Contact information
Practice address
33 ROGER ST, LEWISTON, ME 04240-3328
(207) 784-0108
Mailing address
33 ROGER ST, LEWISTON, ME 04240-3328
(207) 784-0108
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3789
ME
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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