Provider Demographics
NPI:1689683716
Name:WEIR, SHERRY K (DC)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:K
Last Name:WEIR
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 1:13282 S WEST BAY SHORE DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-5456
Mailing Address - Country:US
Mailing Address - Phone:231-946-5816
Mailing Address - Fax:231-946-3756
Practice Address - Street 1:13282 S WEST BAY SHORE DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-5456
Practice Address - Country:US
Practice Address - Phone:231-946-5816
Practice Address - Fax:231-946-3756
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
950 B85030OtherBCBS
P82007OtherBCN
P82007OtherBCN
P82007OtherBCN