Mikayla Kathleen Phetteplace

NPI #1225531130 in Sandusky, Michigan

Provider Information

NPI Number: 1225531130
Entity Type: Individual
Name: Mikayla Kathleen Phetteplace
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Mar 16, 2018
Last Updated: Mar 16, 2018

Practice Location

Address: 227 E SANILAC RD
City: Sandusky
State: Michigan
ZIP Code: 48471-1160
Phone: (810) 648-0330

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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