Mickelson, Charles Glen

Mickelson, Charles Glen is an sole proprietor health care provider with primary practice located at 423 12Th Ave. North , South St. Paul, MN 55075-1915. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pedorthist, which is considered as his primary health care specialty. Mickelson, Charles Glen can be contacted via phone (651) 291-7000.

Contact Information

Primary practice address
423 12Th Ave. North South St. Paul, MN 55075-1915
Phone: (651) 291-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pedorthist 224L00000X Minnesota

Profile Details

NPI number 1568773679
LBN Legal business name Mickelson, Charles Glen
Credentials C.PED.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 24th, 2010
Last updated Nov 9th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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