Healthcare Provider Details

I. General information

NPI: 1215080080
Provider Name (Legal Business Name): DEBORAH MARIE WEBBER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 S BAYSHORE DR
SISTER BAY WI
54234
US

IV. Provider business mailing address

PO BOX 262
SISTER BAY WI
54234
US

V. Phone/Fax

Practice location:
  • Phone: 920-854-2303
  • Fax:
Mailing address:
  • Phone: 920-854-2303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1538012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: