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1154956548
CONNIE JO MICKELSON
SALEM, OR
NPI
1154956548
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
Enumeration Date
2020-03-06
Last Update Date
2020-03-06
Business Address
CONNIE JO MICKELSON RD, LD
2600 CENTER ST NE
SALEM, OR 97301-2669
Phone number: 503-945-2800
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Mailing Address
CONNIE JO MICKELSON RD, LD
2300 INDEPENDENCE HWY
INDEPENDENCE, OR 97351-9438
Phone number: 503-910-5400
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