Organization
DR WALTER J MELLGREN JR DC PA
Active
Other names
Mellgren Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL AARON MELLGREN DC (OWNER/PRESIDENT)
(254) 836-1010
Entity
Organization
Contact information
Practice address
10116 SADDLE CREEK RD, WACO, TX 76708-7290
(254) 836-1010
(254) 836-0177
Mailing address
PO BOX 475, WEST, TX 76691-0475
(254) 836-1010
(254) 836-0177
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00L71L
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/04/2022
Last updated
08/29/2022
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