Individual
DWIGHT MIELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6801 DIXIE HWY, SUITE 136, LOUISVILLE, KY 40258-3913
(502) 933-4327
Mailing address
6801 DIXIE HWY, SUITE 136, LOUISVILLE, KY 40258-3913
(502) 933-4327
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KY1058
KY
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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