Provider Demographics
NPI:1134834526
Name:WOHLERS, NICHOLAS LEVI (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:LEVI
Last Name:WOHLERS
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 1:509 E BYRON NELSON BLVD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-6183
Mailing Address - Country:US
Mailing Address - Phone:817-490-6200
Mailing Address - Fax:
Practice Address - Street 1:509 E BYRON NELSON BLVD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-6183
Practice Address - Country:US
Practice Address - Phone:817-490-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty