Provider Demographics
NPI:1598716326
Name:WEHR, MATT M (DC)
Entity Type:Individual
Prefix:DR
First Name:MATT
Middle Name:M
Last Name:WEHR
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 1:620 S JEFFERS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5351
Mailing Address - Country:US
Mailing Address - Phone:308-221-2880
Mailing Address - Fax:
Practice Address - Street 1:620 S JEFFERS ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5351
Practice Address - Country:US
Practice Address - Phone:308-221-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5102111N00000X
NE1276111N00000X
KS4910111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC462118Medicare PIN
NE278088Medicare PIN
KS062162Medicare PIN