Individual
CHAD MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
18425 BROWNS LAKE RD, RICHMOND, MN 56368-8567
(360) 320-8328
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11320
MN
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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