Individual
RUSTY MIKOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATP
Taxonomy
Speciality
Code
Description
License number
State
247000000X
Health Information Technician
Primary
—
—
247200000X
Other Technician
Primary
90894
TX
Other
Enumeration date
10/07/2019
Last updated
05/29/2026
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