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Individual

MANDY MICKELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
2501 SHELBY RD, LA CROSSE, WI 54601-8037
(608) 788-5700
Mailing address
6232 STATE HIGHWAY 16, SPARTA, WI 54656-3505
(608) 343-1236

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1409-019
WI

Other

Enumeration date
05/14/2008
Last updated
05/14/2008
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