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General NPI Number Information
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NPI Number | 1811199961
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Entity Type | Individual
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Provider Name | MICHELLE KMIEC D.C.
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Gender | Female
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 431 PINE ST G01
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City | BURLINGTON
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State | VT
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Zip | 05401-4726
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Country | US
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Telephone | 802-863-5828
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Fax | 802-863-9619
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Provider Business Mailing Address
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Address Line | 431 PINE ST G01
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City | BURLINGTON
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State | VT
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Zip | 05401-4726
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Country | US
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Telephone | 802-863-5828
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Fax | 802-863-9619
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6072
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License Number State | CO
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