Provider Demographics
NPI:1326483801
Name:HEALTHWISE ASSOCIATES LLC
Entity Type:Organization
Organization Name:HEALTHWISE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHYTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:248-275-5221
Mailing Address - Street 1:4484 VASSAR RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-9118
Mailing Address - Country:US
Mailing Address - Phone:248-275-5221
Mailing Address - Fax:
Practice Address - Street 1:25932 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-1071
Practice Address - Country:US
Practice Address - Phone:248-275-5221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704209317363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty