Provider Demographics
NPI:1194063347
Name:WIERTEL, DEBRA (DC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:WIERTEL
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 HIXSON PIKE STE E
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4466
Mailing Address - Country:US
Mailing Address - Phone:423-355-5126
Mailing Address - Fax:
Practice Address - Street 1:4845 HIXSON PIKE STE E
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4466
Practice Address - Country:US
Practice Address - Phone:423-355-5126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2601111NN1001X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition