CHARLES G MICKELSON, C.PED., Pedorthist SOUTH SAINT PAUL, MN

Contact Information

CHARLES G MICKELSON, C.PED.

423 12TH AVE. NORTH
SOUTH SAINT PAUL, MN 55075-1915

Phone: 651-291-7000
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Pedorthist	224L00000X

Indicates primary specialty

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NPI Profile & details for CHARLES G MICKELSON · (Male)

NPI #	`1568773679`
Status	Active
Credentials	C.PED.
Entity	Individual
Enumeration date	06/24/2010
Last updated	11/09/2010 - About 16 years ago
Sole proprietor ¹	Yes
Identifiers	Not Available
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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CHARLES G MICKELSON, C.PED. – NPI #1568773679Pedorthist

Contact Information

Specialty

Pedorthist

NPI Profile & details for CHARLES G MICKELSON · (Male)

Reviews for CHARLES G MICKELSON

CHARLES G MICKELSON, C.PED. – NPI #1568773679
Pedorthist