Provider Demographics
NPI:1548805724
Name:MICHNO, CAITLYN ANN (DPT)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ANN
Last Name:MICHNO
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 1:22014 390TH ST SW
Mailing Address - Street 2:
Mailing Address - City:BELTRAMI
Mailing Address - State:MN
Mailing Address - Zip Code:56517-9507
Mailing Address - Country:US
Mailing Address - Phone:734-846-0417
Mailing Address - Fax:
Practice Address - Street 1:516 WALSH ST
Practice Address - Street 2:
Practice Address - City:CROOKSTON
Practice Address - State:MN
Practice Address - Zip Code:56716-2757
Practice Address - Country:US
Practice Address - Phone:218-281-9705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10771225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist