Most Relevant Information
Provider Data
| NPI Number: | 1003056961 |
| Provider Name: | MANDI LYNNE MIEDEMA D.C. |
| Entity Type: | Individual |
| Taxonomy Code: | 111N00000X |
| Specialty: | Chiropractor |
| License Number: | 6600 |
Most Important Dates
| Enumeration Date: | 03/04/2009 |
| Last Updated: | 11/15/2010 |
Provider Practice Location
11605 MERIDIAN MARKET VW STE 142
FALCON
CO
808318238
Practice Location Phone/Fax
| Phone: | 7018300431 |
| Fax: |
Provider Mailing Location
11605 MERIDIAN MARKET VW STE 142
FALCON
CO
808318238
Provider Mailing Phone/Fax
| Phone: | 7018300431 |
| Fax: |