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General NPI Number Information
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NPI Number | 1013056472
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Entity Type | Organization
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Legal Business Name | JEFFREY M MIES DC INC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 1747 7TH ST S
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4047
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Country | US
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Telephone | 320-251-0822
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Fax | 320-202-0602
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Provider Business Mailing Address
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Address Line | 1747 7TH ST S
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4047
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Country | US
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Telephone | 320-251-0822
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Fax | 320-202-0602
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY MICHAEL MIES
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Credential | DC
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Telephone | 320-251-0822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2962
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License Number State | MN
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