Individual
JON MICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
300 W 10TH AVE, 004 JAMES, COLUMBUS, OH 43210-1280
(614) 293-3285
(614) 293-2619
Mailing address
300 W 10TH AVE, 004 JAMES, COLUMBUS, OH 43210-1280
(614) 293-3285
(614) 293-2619
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
197506
OH
Other
Enumeration date
06/14/2007
Last updated
07/08/2007
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