Provider Demographics
NPI:1184022899
Name:WEDDLE, MONIQUE (DC)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:
Last Name:WEDDLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1945
Mailing Address - Street 2:
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28459-1945
Mailing Address - Country:US
Mailing Address - Phone:910-755-5483
Mailing Address - Fax:
Practice Address - Street 1:4911 BRIDGER RD
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4474
Practice Address - Country:US
Practice Address - Phone:910-755-5483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor