Provider Demographics
NPI:1417366717
Name:DEBRA C. WIERTEL
Entity Type:Organization
Organization Name:DEBRA C. WIERTEL
Other - Org Name:SIMPLY CHIROPRACTIC 4 YOU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:WIERTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-355-5126
Mailing Address - Street 1:1963 NORTHPOINT BLVD 109
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343
Mailing Address - Country:US
Mailing Address - Phone:423-355-5126
Mailing Address - Fax:423-355-5235
Practice Address - Street 1:1963 NORTHPOINT BLVD 109
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343
Practice Address - Country:US
Practice Address - Phone:423-355-5126
Practice Address - Fax:423-355-5235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty