RICHARD WAYNE MICKELSEN

PROVO, UT
NPI1740250372
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry
(Licence: UT  5336032-1205)
Enumeration Date2006-01-25
Last Update Date2023-08-03
Business Address
Dr. RICHARD WAYNE MICKELSEN M.D.
1300 E CENTER ST
PROVO, UT 84606-3554
Phone number: 801-344-4215
Mailing Address
Dr. RICHARD WAYNE MICKELSEN M.D.
1300 E CENTER ST
PROVO, UT 84606-3554
Phone number: 801-344-4400
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