MEDICARE: DR. VALARIE JEAN HERVEY-WELLS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301007608	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0H23184	OTHER	MI	BSBSM

General Provider Information

NPI Number	:	1407945470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALARIE JEAN HERVEY-WELLS D.C.

Provider Business Mailing Address
First Line	:	8862 ROSELLA ST
Second Line	:
City	:	TAYLOR
State	:	MI
Zip	:	48180-2973
Country	:	US
Telephone Number	:	313-506-4033
Fax Number	:

Provider Business Practice Location Address
First Line	:	4218 PELHAM ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48125-3121
Country	:	US
Telephone Number	:	313-506-4033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	03/29/2024

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