Provider Demographics
NPI:1205030947
Name:WEHRSPAN, GREGG ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:ALLEN
Last Name:WEHRSPAN
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 1:615 SE WHITETAIL LN
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8550
Mailing Address - Country:US
Mailing Address - Phone:515-978-5423
Mailing Address - Fax:
Practice Address - Street 1:615 SE WHITETAIL LN
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8550
Practice Address - Country:US
Practice Address - Phone:515-978-5423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor