Individual
JENNIFER M MIKONCZY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
412 GRAFF CT, GRAND BLANC, MI 48439-1640
(810) 953-3256
Mailing address
412 GRAFF CT, GRAND BLANC, MI 48439-1640
(810) 953-3256
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
02/22/2008
Last updated
12/12/2018
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