Provider Demographics
NPI:1508926148
Name:WEHRMEYER, TODD ERIC (PT)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:ERIC
Last Name:WEHRMEYER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 CHICAGO DR SW
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-1281
Mailing Address - Country:US
Mailing Address - Phone:616-534-0366
Mailing Address - Fax:616-534-0540
Practice Address - Street 1:4120 CHICAGO DR SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-1281
Practice Address - Country:US
Practice Address - Phone:616-534-0366
Practice Address - Fax:616-534-0540
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004108225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI236696Medicare Oscar/Certification