Provider Demographics
NPI:1497156624
Name:HARPHAM, WESLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:
Last Name:HARPHAM
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 1:601 EAST WACKERLY #2
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48703
Mailing Address - Country:US
Mailing Address - Phone:989-631-5910
Mailing Address - Fax:
Practice Address - Street 1:601 E WACKERLY ST STE 2
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-7071
Practice Address - Country:US
Practice Address - Phone:989-607-4322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor