Individual
CHARLES MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
802 8TH AVE SE, PIPESTONE, MN 56164-1734
(507) 825-4259
Mailing address
PO BOX 745, PIPESTONE, MN 56164-0745
(507) 825-4259
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
112690
MN
Other
Enumeration date
01/27/2021
Last updated
01/27/2021
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