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NPI Code Detail

MEDICARE: HENRY WIRTJES

MEDICARE: HENRY WIRTJES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor15266FL

General Provider Information

NPI Number : 1184440661
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY WIRTJES
Provider Business Mailing Address
First Line : 1240 FRONT PLACE, APARTMENT 1201
Second Line :
City : NORTH PORT
State : FL
Zip : 34287
Country : US
Telephone Number : 320-760-0578
Fax Number :
Provider Business Practice Location Address
First Line : 1337 N SUMTER BLVD
Second Line :
City : NORTH PORT
State : FL
Zip : 34286-8072
Country : US
Telephone Number : 877-442-4476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2024
Last Update Date : 11/29/2024

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Directions to “ HENRY WIRTJES ” Practice Location

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