CODY BRAD MICKELSEN

PROVIDENCE, UT
NPI1013159003
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: UT  9806425-1205)
Enumeration Date2009-04-06
Last Update Date2026-07-23
Business Address
CODY BRAD MICKELSEN MD
560 W 465 N STE 604
PROVIDENCE, UT 84332-8006
Phone number: 435-753-1600
Mailing Address
CODY BRAD MICKELSEN MD
560 W 465 N STE 604
PROVIDENCE, UT 84332-8006
Phone number: 435-753-1600
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