Organization
GENESIS CHIROPRACTIC CENTER INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALEXANDER MIELKE DC (PRESIDENT)
(360) 380-4848
Entity
Organization
Contact information
Practice address
5630 3RD ST, FERNDALE, WA 98248
(360) 380-4848
Mailing address
PO BOX 2098, FERNDALE, WA 98248-2098
(360) 380-4848
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00003092
WA
Other
Enumeration date
09/25/2007
Last updated
11/23/2007
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