Provider Demographics
NPI:1366679383
Name:MUELLER KIRK, MICHELLE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:MUELLER KIRK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:M
Other - Last Name:MUELLER GONZALEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:B7 CALLE MADRE PERLA
Mailing Address - Street 2:DORADO DEL MAR
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-2125
Mailing Address - Country:US
Mailing Address - Phone:787-930-7855
Mailing Address - Fax:
Practice Address - Street 1:CALLE EXTENSION SUR 503
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-796-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR125945111N00000X
PR443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor