Individual
MRS. BONNIE LEE MICKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
805 NUCLEUS AVE., COLUMBIA FALLS, MT 59912
(406) 892-5304
(406) 892-4038
Mailing address
597 LEGACY LN, COLUMBIA FALLS, MT 59912
(406) 892-5304
(406) 892-4038
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
—
—
225700000X
Massage Therapist
Primary
909
MT
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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