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General NPI Number Information
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NPI Number | 1104886738
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Entity Type | Organization
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Legal Business Name | WETHERBEE CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 06/10/2009
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Provider Practice Location Address
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Address Line | 8619 W GRAND RIVER AVE SUITE B
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City | BRIGHTON
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State | MI
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Zip | 48116-2384
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Country | US
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Telephone | 810-225-7350
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Fax |
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Provider Business Mailing Address
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Address Line | 8619 W GRAND RIVER AVE SUITE B
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City | BRIGHTON
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State | MI
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Zip | 48116-2384
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Country | US
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Telephone | 810-225-7350
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. HEIDI LYNN WETHERBEE
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Credential |
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Telephone | 810-225-7350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301007958
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License Number State | MI
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