Provider Demographics
NPI:1629145883
Name:WHERRY, CELESTE DAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:DAWN
Last Name:WHERRY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CELESTE
Other - Middle Name:DAWN
Other - Last Name:HECKLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:246 MAIN ST S
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-2587
Mailing Address - Country:US
Mailing Address - Phone:320-587-8787
Mailing Address - Fax:320-587-3430
Practice Address - Street 1:246 MAIN ST S
Practice Address - Street 2:SUITE 4
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-2587
Practice Address - Country:US
Practice Address - Phone:320-587-8787
Practice Address - Fax:320-587-3430
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU75985Medicare UPIN