Provider Demographics
NPI:1154435345
Name:WEBLEY, JAMES D JR (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:WEBLEY
Suffix:JR
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 1:733 N PINE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-1247
Mailing Address - Country:US
Mailing Address - Phone:262-763-7583
Mailing Address - Fax:262-763-8184
Practice Address - Street 1:733 N PINE ST
Practice Address - Street 2:SUITE B
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-1247
Practice Address - Country:US
Practice Address - Phone:262-763-7583
Practice Address - Fax:262-763-8184
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3283-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38897100Medicaid
WI000135508Medicare ID - Type Unspecified
WI38897100Medicaid