person
Mrs. Theresa Micknick, PAC
Medical Physician Assistant in Carbondale, Pennsylvania
NPI 1164774261

Theresa Micknick is a Medical Physician Assistant based in Jermyn, PA and is specialized in Medical. Theresa Micknick practices in Carbondale, PA and has the professional credentials of PAC. The NPI Number for Theresa Micknick is 1164774261 and holds a License No. MA001651L (Pennsylvania).

The current practice location address for Theresa Micknick is 165 Fallbrook St, Carbondale, PA and can be reached out via phone at 570-282-3151.

Location: 165 Fallbrook St, Carbondale, PA, 18433-3611
person
Provider Profile Details
NPI Number
1164774261
Provider Name
Theresa Micknick
Credential
PAC
Provider Entity Type
Individual
Gender
Female
Address
165 Fallbrook St, Carbondale, PA, 18433-3611
Phone Number
570-282-3151
Fax Number
Provider Enumeration Date
10/12/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
165 Fallbrook St
City
State
Zip
18433
Phone Number
570-282-3151
Fax Number
person
Provider Business Mailing Address Details
Address
165 Fallbrook St
City
State
Zip
18433
Phone Number
570-282-3151
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
MA001651L (Pennsylvania)
Definition
Definition to come...
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