Provider Demographics
NPI:1043598709
Name:COLNER, MIKAELA F (DPT)
Entity Type:Individual
Prefix:DR
First Name:MIKAELA
Middle Name:F
Last Name:COLNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 W GLENSHANDRA DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-8797
Mailing Address - Country:US
Mailing Address - Phone:585-469-2035
Mailing Address - Fax:
Practice Address - Street 1:3117 STILLWATER DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7164
Practice Address - Country:US
Practice Address - Phone:928-442-0005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist