Individual
MR. MICHAEL THOMAS MCQUEENEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
114 3RD ST NE, ROLLA, ND 58367-7137
(701) 477-3111
Mailing address
514 3RD ST NE, ROLLA, ND 58367-7220
(732) 277-5330
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0491
ND
Other
Enumeration date
07/31/2012
Last updated
07/31/2012
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