Provider Demographics
NPI:1629432224
Name:WOLFE, HANNAH (DC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:WOLFE
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:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-0322
Mailing Address - Country:US
Mailing Address - Phone:810-212-1200
Mailing Address - Fax:810-212-1202
Practice Address - Street 1:830 W DRYDEN RD
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455-8901
Practice Address - Country:US
Practice Address - Phone:810-212-1200
Practice Address - Fax:810-212-1202
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-09
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIM179201111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor