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NPI Code Detail

MEDICARE: DR. JOHN BRENT WELLMAN DC

MEDICARE: DR. JOHN BRENT WELLMAN DC
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
1111N00000XChiropractorJW002140MI

General Provider Information

NPI Number : 1780664466
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN BRENT WELLMAN DC
Provider Business Mailing Address
First Line : 2531 W MAIN ST
Second Line :
City : LOWELL
State : MI
Zip : 49331-8695
Country : US
Telephone Number : 616-897-8284
Fax Number : 616-897-6810
Provider Business Practice Location Address
First Line : 2531 W MAIN ST
Second Line :
City : LOWELL
State : MI
Zip : 49331-8695
Country : US
Telephone Number : 616-897-8284
Fax Number : 616-897-6810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JOHN BRENT WELLMAN DC” Practice Location

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