Organization
GRANITE CITY CHIROPRACTIC, INC
Active
Other names
New Richland Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND W MIELKE DC (PRESIDENT)
(507) 463-3811
Entity
Organization
Contact information
Practice address
131 SOUTH BROADWAY, NEW RICHLAND, MN 56072
(507) 463-3811
(507) 463-3812
Mailing address
PO BOX 441, NEW RICHLAND, MN 56072-0441
(507) 463-3811
(507) 463-3812
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1496
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3KO36GR
BLUE CROSS BLUE SHIELD
MN
Enumeration date
12/05/2006
Last updated
11/18/2014
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