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MR. JOHN RAYMOND MIKULA JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CTRS

Contact information

Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(901) 523-8990
Mailing address
374 SILVERTHORN DR NW, MARIETTA, GA 30064
(352) 246-2124

Taxonomy

Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
43701
TN

Other

Enumeration date
06/10/2006
Last updated
02/11/2016
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