Individual
DR. MICHAEL MONGIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, CACCP
Contact information
Practice address
1120 HAVEL DR SW, MARIETTA, GA 30008-8149
(808) 275-6597
Mailing address
1120 HAVEL DR SW, MARIETTA, GA 30008-8149
(808) 275-6597
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010773
GA
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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