Individual
OLIVIA MIKAELIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 BONFORTE BLVD, PUEBLO, CO 81001-4901
(719) 549-2530
Mailing address
2200 BONFORTE BLVD, PUEBLO, CO 81001-4901
(719) 549-2530
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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