Provider Demographics
NPI:1881193027
Name:WOOTEN-TOERING, KIMBER (DC)
Entity Type:Individual
Prefix:
First Name:KIMBER
Middle Name:
Last Name:WOOTEN-TOERING
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 1:5815 RED ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49127-1142
Mailing Address - Country:US
Mailing Address - Phone:269-429-5882
Mailing Address - Fax:269-429-9441
Practice Address - Street 1:5815 RED ARROW HWY
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MI
Practice Address - Zip Code:49127-1142
Practice Address - Country:US
Practice Address - Phone:269-429-5882
Practice Address - Fax:269-429-9441
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor