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1871945618
SHAUN MICKELSEN
LAYTON, UT
NPI
1871945618
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: UT 363AM0700X)
Enumeration Date
2016-07-05
Last Update Date
2016-10-06
Business Address
Mr. SHAUN MICKELSEN PA-C
2121 N 1700 W
LAYTON, UT 84041-8803
Phone number: 801-773-4840
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Mailing Address
Mr. SHAUN MICKELSEN PA-C
PO BOX 337
LAYTON, UT 84041-0337
Phone number: 801-773-4840
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