Organization Name: | MICKO CHIROPRACTIC PC |
NPI Number: | 1699923946 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AARON MICKO (CHIROPRACTOR) |
Mailing Address: | 1203 E 4th Ave Suite 101 Milbank |
State: | SD US |
Postal Code: | 572521543 |
Phone Number: | 6054329561 |
Fax Number: | 6054329562 |
NPI Enumeration Date: | 08/28/2008 |
NPI Last Update Date: | 08/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 1120 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |