Mikota, Bruce Douglas

Mikota, Bruce Douglas is an sole proprietor health care provider with primary practice located at 111 West Rutledge Avenue , Gaffney SC 29340. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Mikota, Bruce Douglas can be contacted via phone (864) 489-2444.

Contact Information

Primary practice address
111 West Rutledge Avenue Gaffney SC 29340
Fax: (864) 489-6948
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 697 South Carolina
Chiropractic Providers / Chiropractor 111N00000X 799 North Carolina

Profile Details

NPI number 1831126606
LBN Legal business name Mikota, Bruce Douglas
Credentials DC CCSP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 27th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831126606 NPPES
South Carolina MEDICAID CHO697

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