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General NPI Number Information
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NPI Number | 1700969284
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Entity Type | Individual
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Provider Name | DOUGLAS L. WILLEMIN D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 500 S MAIN ST STE 2
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City | SHERIDAN
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State | MI
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Zip | 48884-9775
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Country | US
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Telephone | 989-291-3202
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Fax | 989-291-3203
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Provider Business Mailing Address
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Address Line | PO BOX 338
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City | SHERIDAN
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State | MI
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Zip | 48884-0338
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Country | US
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Telephone | 989-291-3202
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Fax | 989-291-3203
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2301004754
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License Number State | MI
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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 | CHIR002580
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License Number State | GA
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