Individual
PHILIP ROBERT MIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6405 FRANCE AVE S STE W200, EDINA, MN 55435-2186
(612) 365-5000
(952) 836-3950
Mailing address
6405 FRANCE AVE S STE W200, EDINA, MN 55435-2186
(612) 365-5000
(952) 836-3950
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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