Individual
JONATHAN MICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6475 170TH AVE, ROYALTON, MN 56373-3818
(320) 431-4270
Mailing address
6475 170TH AVE, ROYALTON, MN 56373-3818
(320) 431-4270
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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