Healthcare Provider Details

I. General information

NPI: 1801057906
Provider Name (Legal Business Name): MIELE FAMILY CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 WESTMINSTER DR
WILLIAMSPORT PA
17701-3944
US

IV. Provider business mailing address

1040 WESTMINSTER DR
WILLIAMSPORT PA
17701-3944
US

V. Phone/Fax

Practice location:
  • Phone: 570-327-1965
  • Fax: 570-327-1967
Mailing address:
  • Phone: 570-327-1965
  • Fax: 570-327-1967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberDC003960L
License Number StatePA

VIII. Authorized Official

Name: DR. URSULA CATHERINE MIELE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 570-327-1965