Individual
MS. JESSICA MIKACEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
172 COBBLESTONE LN, BURNSVILLE, MN 55337-4578
(763) 201-8191
Mailing address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369-2684
(763) 201-8191
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9098
MN
Other
Enumeration date
07/25/2012
Last updated
05/13/2021
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