Individual
MISS MELISSA NICOLE MIKESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
209 S KINGSHIGHWAY ST, SAINT CHARLES, MO 63301-1693
(314) 971-5355
Mailing address
137 HARVEST GRV, IMPERIAL, MO 63052-3843
(314) 971-5355
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2017012621
MO
Other
Enumeration date
07/12/2017
Last updated
07/21/2022
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