Organization
MIRACLE FAMILY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER RENEE MIRACLE D.C. (DOCTOR OF CHIROPRACTIC/OWNER)
(765) 825-9343
Entity
Organization
Contact information
Practice address
1826 N GRAND AVE, CONNERSVILLE, IN 47331-2859
(765) 825-9343
Mailing address
1826 N GRAND AVE, CONNERSVILLE, IN 47331-2859
(765) 825-9343
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002523A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457660433
BC/BS
—
Enumeration date
07/22/2011
Last updated
07/22/2011
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