| Michaelsen Chiropractic Center, P.c. | |
|
645 S Broadway Ave, Suite 1, Tyler, TX 75701-1676 | |
| (903) 593-5200 | |
| (903) 535-9412 |
| Full Name | Michaelsen Chiropractic Center, P.c. |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 645 S Broadway Ave, Tyler, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053597906 | NPI | - | NPPES |
| 00H42E | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | F002316 (Texas) | Primary |
| Provider Name | Mark R Michaelsen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1902832686 PECOS PAC ID: 4385806280 Enrollment ID: I20131021001480 |
| Provider Name | Tammy L Michaelsen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1659302107 PECOS PAC ID: 1557523453 Enrollment ID: I20140505000314 |
| Mailing Address | Practice Location Address |
|---|---|
| Michaelsen Chiropractic Center, P.c. 645 S Broadway Ave, Suite 1, Tyler, TX 75701-1676 Ph: (903) 593-5200 | Michaelsen Chiropractic Center, P.c. 645 S Broadway Ave, Suite 1, Tyler, TX 75701-1676 Ph: (903) 593-5200 |
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