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Organization

MIKULA CHIROPRACTIC, P.C.

Active
Other names
Mikula Chiropractic Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN PATRICK MIKULA D.C. (PRESIDENT)
(616) 365-0255
Entity
Organization

Contact information

Practice address
4056 PLAINFIELD AVE NE, SUITE E, GRAND RAPIDS, MI 49525-1630
(616) 365-0255
(616) 365-0975
Mailing address
4056 PLAINFIELD AVE NE, SUITE E, GRAND RAPIDS, MI 49525-1630
(616) 365-0255
(616) 365-0975

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007183
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0D15065
BLUE CARE NETWORK
MI
01
0D17680
BLUE CARE NETWORK
MI
05
3269896
MI
05
4443376
MI
01
950D120100
BLUE CROSS/BLUE SHIELD
MI
01
950D120110
BLUE CROSS/BLUE SHIELD
MI
Enumeration date
07/23/2008
Last updated
07/24/2008
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