Provider Demographics
NPI:1184673618
Name:WAHLER, BRUCE A (DC)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:A
Last Name:WAHLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 EBENEZER RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9288
Mailing Address - Country:US
Mailing Address - Phone:803-366-7778
Mailing Address - Fax:803-328-2225
Practice Address - Street 1:2241 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9288
Practice Address - Country:US
Practice Address - Phone:803-366-7778
Practice Address - Fax:803-328-2225
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC2947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor