Individual
JOHN PAUL MICLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1369 MONTGOMERY ST, CUSTER, SD 57730-8246
(605) 787-2719
Mailing address
245 MONTGOMERY ST, CUSTER, SD 57730-1019
(347) 952-3307
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2651
SD
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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