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1902562382
CHAD MICKELSON
SAINT CLOUD, MN
NPI
1902562382
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MN 11320)
Enumeration Date
2021-11-10
Last Update Date
2021-11-10
Business Address
CHAD MICKELSON DPT
4801 VETERANS DR
SAINT CLOUD, MN 56303-2015
Phone number: 320-252-1670
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Mailing Address
CHAD MICKELSON DPT
18425 BROWNS LAKE RD
RICHMOND, MN 56368-8567
Phone number: 360-320-8328
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