Healthcare Provider Details

I. General information

NPI: 1952649394
Provider Name (Legal Business Name): ERIC EDWIN WHEDON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 10/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W CARLETON RD
HILLSDALE MI
49242-1354
US

IV. Provider business mailing address

401 W CARLETON RD
HILLSDALE MI
49242-1354
US

V. Phone/Fax

Practice location:
  • Phone: 517-437-0900
  • Fax:
Mailing address:
  • Phone: 517-437-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010122
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: