Tracy Mickelsen, CSFA

NPI 1801073655 · on the registry since 2008 · sole proprietor

Practice

Address: 3015 E Magic View Dr
Meridian, ID 83642
Phone: (208) 855-2410
Fax: (208) 482-5515
Organisation at this address: Allied Orthopaedics, Llc
Direct Orthopedic Care Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 12

Registry record

Primary taxonomy: 363AS0400X
363AS0400X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2017-12-07

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 Idaho