Provider Demographics
NPI:1982681052
Name:WESSLER, GREGG L (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:L
Last Name:WESSLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16354 NE 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4004
Mailing Address - Country:US
Mailing Address - Phone:305-940-0040
Mailing Address - Fax:305-940-0094
Practice Address - Street 1:16354 NE 26TH AVE
Practice Address - Street 2:
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4004
Practice Address - Country:US
Practice Address - Phone:305-940-0040
Practice Address - Fax:305-940-0094
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55284AMedicare ID - Type Unspecified
FLU60532Medicare UPIN