Jon Micklis

NPI 1205337797 · on the registry since 2018

Practice

Address: 2400 W Dunlap Ave Ste 100
Phoenix, AZ 85021
Phone: (602) 325-2485
Organisation at this address: Dynometrics Inc
Bowsers Garden Llc
Great Horizons Llc
Physiotherapy Associates Inc
Center For Autism & Related Disorders, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 153

Registry record

Primary taxonomy: 103K00000X
103K00000X
Also registered as: 103K00000X
Licence states on file: CA, AZ
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2018-02-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona