Individual
CORY MICKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 N LOY LAKE RD STE J, SHERMAN, TX 75090-2837
(903) 487-5520
Mailing address
PO BOX 1466, POTTSBORO, TX 75076-1466
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1243372
TX
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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