MEDICARE: KIMBER WOOTEN-TOERING 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	2301006017	MI

General Provider Information

NPI Number	:	1881193027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBER WOOTEN-TOERING D.C.

Provider Business Mailing Address
First Line	:	5815 RED ARROW HWY
Second Line	:
City	:	STEVENSVILLE
State	:	MI
Zip	:	49127-1142
Country	:	US
Telephone Number	:	269-429-5882
Fax Number	:	269-429-9441

Provider Business Practice Location Address
First Line	:	5815 RED ARROW HWY
Second Line	:
City	:	STEVENSVILLE
State	:	MI
Zip	:	49127-1142
Country	:	US
Telephone Number	:	269-429-5882
Fax Number	:	269-429-9441

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

Provider Enumeration Date	:	02/02/2018
Last Update Date	:	02/02/2018

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