Provider Demographics
NPI:1881635746
Name:WESTERBEKE, TONYA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:TONYA
Middle Name:ANN
Last Name:WESTERBEKE
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 1:10990 CHICAGO DRIVE
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464
Mailing Address - Country:US
Mailing Address - Phone:616-546-3500
Mailing Address - Fax:616-546-3501
Practice Address - Street 1:10990 CHICAGO DRIVE
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464
Practice Address - Country:US
Practice Address - Phone:616-546-3500
Practice Address - Fax:616-546-3501
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P34120Medicare ID - Type Unspecified
MIV09705Medicare UPIN