Individual
MICHAEL EDWARD MIRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CONTRACTOR
Contact information
Practice address
1812 7TH ST SW, MINOT, ND 58701-6409
(661) 236-6963
Mailing address
1812 7TH ST SW, MINOT, ND 58701-6409
(661) 236-6963
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
000046096
ND
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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