Provider Demographics
NPI:1619145265
Name:WERTIN, JOHN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:WERTIN
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 1:3885 BUTTERNUT DR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:KS
Mailing Address - Zip Code:66535-9643
Mailing Address - Country:US
Mailing Address - Phone:785-313-2839
Mailing Address - Fax:
Practice Address - Street 1:3885 BUTTERNUT DR
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:KS
Practice Address - Zip Code:66535-9643
Practice Address - Country:US
Practice Address - Phone:785-313-2839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-01759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor