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General NPI Number Information
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NPI Number | 1417366717
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Entity Type | Organization
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Legal Business Name | DEBRA C. WIERTEL
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 1963 NORTHPOINT BLVD 109
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City | HIXSON
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State | TN
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Zip | 37343
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Country | US
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Telephone | 423-355-5126
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Fax | 423-355-5235
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Provider Business Mailing Address
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Address Line | 1963 NORTHPOINT BLVD 109
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City | HIXSON
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State | TN
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Zip | 37343
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Country | US
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Telephone | 423-355-5126
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Fax | 423-355-5235
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Authorized Official
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Title or Position | CHIROPRACTIC
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Name | DR. DEBRA CHRISTINA WIERTEL
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Credential | DC
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Telephone | 423-355-5126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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