Provider Demographics
NPI:1467549055
Name:WEHR, DAVID P (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:WEHR
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 1:1570 36TH AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-7268
Mailing Address - Country:US
Mailing Address - Phone:309-797-4155
Mailing Address - Fax:309-797-2235
Practice Address - Street 1:1570 36TH AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265
Practice Address - Country:US
Practice Address - Phone:309-797-4155
Practice Address - Fax:309-764-7679
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0008132030OtherBLUE CROSS BLUE SHIELD
IL383669494OtherTAX I.D. NUMBER
IL383669494OtherTAX I.D. NUMBER
IL0008132030OtherBLUE CROSS BLUE SHIELD