Organization
KATO PHYSICAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TJODE MAURETTE MICKELSON (OWNER)
(314) 398-5800
Entity
Organization
Contact information
Practice address
800 SOUTH FRONT STREET, MANKATO, MN 56001
(507) 594-9100
Mailing address
100 THOMAS DRIVE, APT 209, MANKATO, MN 56001
(314) 398-5800
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
163W00000X
Registered Nurse
—
—
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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