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Organization

MIRACLE MILE CHIROPRACTIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KRISTINA L MILLS DC (OWNER)
(360) 330-1312
Entity
Organization

Contact information

Practice address
1102 KRESKY AVE, CENTRALIA, WA 98531-3732
(360) 330-1312
(360) 330-1320
Mailing address
110 HAM RD, CENTRALIA, WA 98531-5202
(360) 330-1312
(360) 330-1320

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH00034048
WA
111N00000X
Chiropractor
Primary
CH00034049
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0165763
KRISTINA MILLS L&I
WA
01
0165764
GROUP L&I
WA
01
0165765
CHAD MILLS L&I
WA
05
8349722
WA
05
8349730
WA
01
8869221
CORP PIN
WA
01
8869913
CHADS MEDICARE PTAN
WA
01
8870107
KRISTINA MEDICARE
WA
01
8903893
L&I CRIME CHAD MILLS DC
WA
01
DB2803
GROUP MEDICARE RAILROAD
WA
01
P00096548
CHAD MILLS DC RAILROAD
WA
Enumeration date
02/27/2007
Last updated
04/18/2008
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