Provider Demographics
NPI:1558577288
Name:PFAHLER, PAULA MARIE (DC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:MARIE
Last Name:PFAHLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812A SHIP ST
Mailing Address - Street 2:
Mailing Address - City:ST JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2183
Mailing Address - Country:US
Mailing Address - Phone:269-983-1160
Mailing Address - Fax:
Practice Address - Street 1:812A SHIP ST
Practice Address - Street 2:
Practice Address - City:ST JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2183
Practice Address - Country:US
Practice Address - Phone:269-983-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor