Individual
MIKISO MIZUKI JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 EMANCIPATION DR, VAMC HAMPTON, HAMPTON, VA 23667-0001
(757) 722-9961
Mailing address
4458A OCEAN VIEW AVE, VIRGINIA BEACH, VA 23455-1543
(757) 464-9599
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101048885
VA
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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