Individual
MR. DEWAYNE MARK MIRTSCHING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3780 FM 972, GEORGETOWN, TX 78626-1501
(512) 864-1600
Mailing address
PO BOX 96, WALBURG, TX 78673-0096
(512) 864-1600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4124531
AETNA
—
01
—
601429
BCBS
—
05
—
C06014297
—
TX
Enumeration date
07/29/2005
Last updated
05/05/2017
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