Individual
ROBBY JOHN MICKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1212 BROADRICK DR, DALTON, GA 30720-2503
(706) 270-8008
(706) 259-6426
Mailing address
1501 SUMMER GATE WAY APT 12, DALTON, GA 30720-5385
(706) 259-6426
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002859
GA
Other
Enumeration date
11/28/2024
Last updated
11/28/2024
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