Provider Demographics
NPI:1598880338
Name:DR CATHERINE I MICKLER
Entity Type:Organization
Organization Name:DR CATHERINE I MICKLER
Other - Org Name:WELLNESS BY DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MICKLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:229-333-7711
Mailing Address - Street 1:1808 PLUM ST
Mailing Address - Street 2:STE C
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31601-7527
Mailing Address - Country:US
Mailing Address - Phone:229-333-7711
Mailing Address - Fax:229-333-7712
Practice Address - Street 1:1808 PLUM ST
Practice Address - Street 2:STE C
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-7527
Practice Address - Country:US
Practice Address - Phone:229-333-7711
Practice Address - Fax:229-333-7712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty