Provider Demographics
NPI:1528179330
Name:WHEELER ENGH, CARRIE LYN (DC)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:LYN
Last Name:WHEELER ENGH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:LYN
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2410 FAIR OAKS BLVD
Mailing Address - Street 2:STE 160
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7630
Mailing Address - Country:US
Mailing Address - Phone:916-483-2359
Mailing Address - Fax:916-483-0329
Practice Address - Street 1:2410 FAIR OAKS BLVD
Practice Address - Street 2:STE 160
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-483-2359
Practice Address - Fax:916-483-0329
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU92951Medicare UPIN
CADC0255340Medicare ID - Type Unspecified