Provider Demographics
NPI:1487642229
Name:ROCKERS, WESLEY SHAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:SHAWN
Last Name:ROCKERS
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 1:2836 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47712-5822
Mailing Address - Country:US
Mailing Address - Phone:812-426-1131
Mailing Address - Fax:812-425-6260
Practice Address - Street 1:2836 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5822
Practice Address - Country:US
Practice Address - Phone:812-426-1131
Practice Address - Fax:812-425-6260
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002213A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INV06034Medicare UPIN
IN230600Medicare ID - Type Unspecified