Healthcare Provider Details

I. General information

NPI: 1811950108
Provider Name (Legal Business Name): DAVID EUGENE WOHL MS ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1186 CLEAVER RD
CARO MI
48723-1150
US

IV. Provider business mailing address

250 E ELMWOOD RD
CARO MI
48723-8700
US

V. Phone/Fax

Practice location:
  • Phone: 989-673-4999
  • Fax:
Mailing address:
  • Phone: 989-672-2093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: