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1649510462
MICKENZIE JO CRISWELL
LOUISVILLE, KY
NPI
1649510462
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: OH 08834)
Enumeration Date
2013-02-15
Last Update Date
2013-02-15
Business Address
-- MICKENZIE JO CRISWELL PTA
303 N HURSTBOURNE PKWY SUITE 200
LOUISVILLE, KY 40222-5185
Phone number: 502-412-5847
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Mailing Address
-- MICKENZIE JO CRISWELL PTA
202 N MADISON ST
REPUBLIC, OH 44867-9790
Phone number: 419-618-0295
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