Provider Demographics
NPI:1376513317
Name:POHLEN, WILLIAM J (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:POHLEN
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 1:28098 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051-2316
Mailing Address - Country:US
Mailing Address - Phone:586-949-0123
Mailing Address - Fax:586-228-9019
Practice Address - Street 1:28098 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-2316
Practice Address - Country:US
Practice Address - Phone:586-949-0123
Practice Address - Fax:586-228-9019
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI009406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M35060Medicare PIN