MRS. Theresa Micknick, PAC
NPI #1164774261 in Carbondale, Pennsylvania
Provider Information
- NPI Number
- 1164774261
- Entity Type
- Individual
- Name
- MRS. Theresa Micknick, PAC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PAC
- Enumeration Date
- Oct 12, 2012
- Last Updated
- Oct 12, 2012
Practice Location
- Address
- 165 FALLBROOK ST
- City
- Carbondale
- State
- Pennsylvania
- ZIP Code
- 18433
- Phone
- (570) 282-3151
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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