Individual
MR. ANTHONY CHRISTOPHER MIELCAREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
801 SOUTH ST, RACINE, WI 53402-3846
(262) 633-6069
(262) 656-3315
Mailing address
801 SOUTH ST, RACINE, WI 53402-3846
(262) 633-6069
(262) 656-3315
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
636-019
WI
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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