Michel Yves Tetrault, DC
Individual provider Active NPI Chiropractor · Shafter, CA
NPI 1265442149 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1265442149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 17556 (CA)
- Practice address
- 655 S Central Valley Hwy
Shafter, CA 93263-2790 - Phone
- (661) 746-9194
- Fax
- (661) 459-9197
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17556 | CA | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 17556 | CA | Yes |
Addresses
Primary practice location
655 S Central Valley Hwy
Shafter, CA 93263-2790
Mailing address
659 S Central Valley Hwy
Shafter, CA 93263-2790
Phone (661) 746-9194
Other providers in Shafter, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.