Randy J Mickelson, PA

NPI #1255335725 in Viroqua, Wisconsin

Provider Information

NPI Number: 1255335725
Entity Type: Individual
Name: Randy J Mickelson, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jun 13, 2005
Last Updated: Mar 23, 2016

Practice Location

Address: 407 S MAIN ST
City: Viroqua
State: Wisconsin
ZIP Code: 54665-2100
Phone: (608) 637-3195

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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