Provider Demographics
NPI:1821374646
Name:WANGLER, ALEXIS MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:MARIE
Last Name:WANGLER
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 1:3292 N M 33
Mailing Address - Street 2:
Mailing Address - City:ROSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48654-9416
Mailing Address - Country:US
Mailing Address - Phone:989-685-2631
Mailing Address - Fax:
Practice Address - Street 1:3292 N M 33
Practice Address - Street 2:
Practice Address - City:ROSE CITY
Practice Address - State:MI
Practice Address - Zip Code:48654-9416
Practice Address - Country:US
Practice Address - Phone:989-685-2631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009802111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor