Individual
JENNA MICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
10609 IH 10 W STE 201, SAN ANTONIO, TX 78230-1673
(210) 344-5437
Mailing address
13615 WELLCREST, SAN ANTONIO, TX 78232-5907
(210) 344-5437
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1233526
TX
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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