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
Phone: (864) 489-2444
Fax: (864) 489-6948
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831126606 | NPPES |
| South Carolina | MEDICAID | CHO697 |
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