Provider Demographics
NPI:1841348596
Name:WHEELOCK, ANDREW GEORGE (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GEORGE
Last Name:WHEELOCK
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 1:34 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1922
Mailing Address - Country:US
Mailing Address - Phone:508-340-8497
Mailing Address - Fax:508-797-3222
Practice Address - Street 1:1 W BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1265
Practice Address - Country:US
Practice Address - Phone:508-340-8497
Practice Address - Fax:508-797-3222
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3008111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic