Provider Demographics
NPI:1801057906
Name:MIELE FAMILY CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:MIELE FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:MIELE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-327-1965
Mailing Address - Street 1:1040 WESTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3944
Mailing Address - Country:US
Mailing Address - Phone:570-327-1965
Mailing Address - Fax:570-327-1967
Practice Address - Street 1:1040 WESTMINSTER DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3944
Practice Address - Country:US
Practice Address - Phone:570-327-1965
Practice Address - Fax:570-327-1967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003960L111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU02523Medicare UPIN
PAMI1478012Medicare PIN