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General NPI Number Information
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NPI Number | 1912386566
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Entity Type | Organization
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Legal Business Name | UP NORTH CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 10975 E BREWERY CREEK LN
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-6225
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Country | US
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Telephone | 231-947-0755
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Fax |
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Provider Business Mailing Address
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Address Line | 10975 E BREWERY CREEK LN
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-6225
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Country | US
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Telephone | 231-947-0755
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. HEATHER K WEAVER
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Credential | D.C
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Telephone | 231-499-0237
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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 | 2301010248
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License Number State | MI
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