Brandon Shawn Mickelson, PA-C

NPI #1790544534 in Draper, Utah

Provider Information

NPI Number: 1790544534
Entity Type: Individual
Name: Brandon Shawn Mickelson, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Mar 14, 2024
Last Updated: May 9, 2024

Practice Location

Address: 11760 S 700 E STE 112
City: Draper
State: Utah
ZIP Code: 84020-6605
Phone: (801) 882-9995

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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