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Organization

MIKULA CHIROPRACTIC CENTER

Active
Other names
mikula chiropractic pc
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CHERYL A. MERKLER (BILLING ASSOCIATE)
(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
111N00000X
Chiropractor
2301007184
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0D115053
BLUE CARE NETWORK
MI
01
0D15065
BLUE CARE NETWORK
MI
01
0P61830
MEDICARE PROVIDER ENROLLMENT PTAN
MI
05
13269896
MI
05
14443376
MI
01
950D120100
BLUE CROSS/BLUE SHIELD
MI
01
950D120110
BLUE CROSS/BLUE SHIELD
MI
01
OD15062753
BLUE CARE NETWORK
MI
01
P61830001
MEDICARE PROVIDER ENROLLMENT PTAN
MI
01
P61830002
MEDICARE PROVIDER ENROLLMENT PTAN
MI
Enumeration date
12/17/2008
Last updated
12/17/2008
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