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NPI Code Detail

MEDICARE: JEFFREY M MIES DC

MEDICARE:   JEFFREY M MIES  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2962MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13C433MIOTHERMNBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1295831469
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY M MIES DC
Provider Business Mailing Address
First Line : 1747 7TH ST S
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-4047
Country : US
Telephone Number : 320-251-0822
Fax Number : 320-202-0602
Provider Business Practice Location Address
First Line : 1747 7TH ST S
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-4047
Country : US
Telephone Number : 320-251-0822
Fax Number : 320-202-0602
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 07/08/2007

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Directions to “ JEFFREY M MIES DC” Practice Location

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