Individual
BRIAN K MIKESELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
750 RIDGE RD, MONMOUTH JUNCTION, NJ 08852-2725
(732) 329-4044
Mailing address
13 PITTSFIELD ST, CRANFORD, NJ 07016-1829
(908) 276-7682
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00045700
NJ
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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