Wautier Wellness, Inc
Organization Active NPI Chiropractor · Gwinn, MI
NPI 1710116249 · NPPES record last updated Oct 2, 2014
Key facts
- NPI
- 1710116249
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2301009330 (MI)
- Legal business name
- WAUTIER WELLNESS, INC
- Practice address
- 55 W. Hwy M -35
Gwinn, MI 49841-9178 - Phone
- (906) 346-9000
- Fax
- (906) 346-6449
- NPI assigned
- Jul 6, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Stephanie Woodaz Wautier, D.C.
- Title
- Chiropractor/Owner
- Phone
- (906) 346-9000
Practitioners 3
-
Stephanie Woodaz Wautier, D.C.
-
Collene Nicole Froberg, D.C.
-
Bethany Ann Vallar, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091202000621 | MI | Part B Supplier - Clinic/Group Practice | 0840339917 |
Receives reassigned benefits from 1 practitioner Practice locations: Marquette, MI |
National Provider Directory
Locations
2250 US 41 S
Ste B
Marquette, MI 49855
2250 US Highway 41 S
Marquette, MI 49855
Phone (906) 225-1135
6044 US 41 S
Ste 2
Marquette, MI 49855
Phone (906) 273-2777
2250 US 41 S
Marquette, MI 49855
Phone (906) 273-2777
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2301009330 | MI | Yes |
Addresses
Primary practice location
55 W. Hwy M -35
Gwinn, MI 49841-9178
Mailing address
55 W. Hwy M 35
Gwinn, MI 49841-9178
Phone (906) 346-9000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M74030006 | Other | MI | MEDICARE NUMBER |
Other providers in Gwinn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.