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Mr. Mark R Michaelsen, DC
Chiropractor in Tyler, Texas
NPI 1902832686

Mark R Michaelsen is a Chiropractor based in Tyler, TX. Mark R Michaelsen practices in Tyler, TX and has the professional credentials of DC. The NPI Number for Mark R Michaelsen is 1902832686 and holds a License No. 5712 (Texas).

The current practice location address for Mark R Michaelsen is 645 S Broadway Ave, Tyler, TX and can be reached out via phone at 903-593-5200 and via fax at 903-535-9412.

Location: 645 S Broadway Ave, Tyler, TX, 75701-1676
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902832686
Provider Name
Mark R Michaelsen
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
645 S Broadway Ave, Tyler, TX, 75701-1676
Phone Number
903-593-5200
Fax Number
903-535-9412
Provider Enumeration Date
06/24/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
039541001 05 TX
institution
Provider Business Practice Location Address Details
Address
645 S Broadway Ave
City
Tyler
State
Texas
Zip
75701-1676
Phone Number
903-593-5200
Fax Number
903-535-9412
person
Provider Business Mailing Address Details
Address
645 S Broadway Ave
City
Tyler
State
Texas
Zip
75701-1676
Phone Number
903-593-5200
Fax Number
903-535-9412
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
5712 (Texas)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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