Individual
WILLIAM J MISKELLY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D. C.
Contact information
Practice address
2811 LOWER HUNTINGTON RD, FORT WAYNE, IN 46809-2616
(260) 747-1596
(260) 747-1597
Mailing address
2811 LOWER HUNTINGTON ROAD, FORT WAYNE, IN 46809-2616
(260) 747-1596
(260) 747-1597
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000497A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000175462
BLUE CROSS BLUE SHIELD
IN
Enumeration date
03/16/2006
Last updated
07/08/2007
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