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Individual

THOMAS CARL MICKELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1544 HWY 59 SE, THIEF RIVER FALLS, MN 56701-2387
(218) 681-4574
(218) 681-4594
Mailing address
PO BOX 387, THIEF RIVER FALLS, MN 56701-0387
(218) 681-4574
(218) 681-4594

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1695
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
705027500
MN
Enumeration date
11/09/2006
Last updated
01/18/2017
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