Provider Demographics
NPI:1659496537
Name:MICKLER, CATHERINE ISABELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ISABELLE
Last Name:MICKLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition