Provider Demographics
NPI:1578763538
Name:WETTER, MICHAEL S (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:WETTER
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 1:3408 AVIATION BLVD
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-1954
Mailing Address - Country:US
Mailing Address - Phone:772-410-5167
Mailing Address - Fax:
Practice Address - Street 1:809 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-8557
Practice Address - Country:US
Practice Address - Phone:772-429-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor