Provider Demographics
NPI:1679821771
Name:WEST, BERNADETTE CLAIRE (DC)
Entity Type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:CLAIRE
Last Name:WEST
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 1:3819 4 MILE RD N STE B
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-9344
Mailing Address - Country:US
Mailing Address - Phone:989-684-0018
Mailing Address - Fax:
Practice Address - Street 1:5168 US HIGHWAY 31 N STE 102
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:MI
Practice Address - Zip Code:49690-9349
Practice Address - Country:US
Practice Address - Phone:231-938-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor