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General NPI Number Information
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NPI Number | 1588136436
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Entity Type | Organization
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Legal Business Name | M WHEELER PLLC
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 3904 E MULLAN AVE STE C
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City | POST FALLS
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State | ID
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Zip | 83854-4009
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Country | US
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Telephone | 360-789-9180
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Fax |
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Provider Business Mailing Address
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Address Line | 3904 E MULLAN AVE STE C
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City | POST FALLS
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State | ID
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Zip | 83854-4009
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Country | US
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Telephone | 208-981-0093
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Fax |
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Authorized Official
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Title or Position | OWNER/DC
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Name | DR. MATTHAN JAYCOB WHEELER
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Credential | DC
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Telephone | 208-981-0093
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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 |
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License Number State |
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