Michael Charles Lick
Michael Charles Lick is a Physician Assistant in Bloomington, Minnesota. Practices as a sole proprietor. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
4300 Market Pte Dr Ste 100Bloomington, MN 55435-5435
Phone: (457) 495-2767
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1023793932 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 19, 2023 |
| Last updated in NPPES | January 13, 2025 |
| Certification date | January 13, 2025 |
| Mailing address | 115 W 5th St # 2, Duluth, MN 55806-2729 |
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