Provider Demographics
NPI:1407521909
Name:HERRON CHIROPRACTIC AND WELLNE LLC
Entity Type:Organization
Organization Name:HERRON CHIROPRACTIC AND WELLNE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON HERRON
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-218-0855
Mailing Address - Street 1:2506 CROSSING CIR STE A
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7955
Mailing Address - Country:US
Mailing Address - Phone:231-421-3333
Mailing Address - Fax:
Practice Address - Street 1:2506 CROSSING CIR STE A
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7955
Practice Address - Country:US
Practice Address - Phone:231-421-3333
Practice Address - Fax:231-421-3355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center