Michael Charles Lick
NPI #1023793932 in Bloomington, Minnesota
Provider Information
- NPI Number
- 1023793932
- Entity Type
- Individual
- Name
- Michael Charles Lick
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Jun 19, 2023
- Last Updated
- Jan 13, 2025
Practice Location
- Address
- 4300 MARKET PTE DR STE 100
- City
- Bloomington
- State
- Minnesota
- ZIP Code
- 55435-5435
- Phone
- (457) 495-2767
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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