Provider Demographics
NPI:1710332408
Name:WOLFE FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:WOLFE FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:C
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-212-1200
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty