Provider Demographics
NPI:1386696771
Name:WENSCH, MONIQUE MELANIE (DC)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:MELANIE
Last Name:WENSCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MONIQUE
Other - Middle Name:MELANIE
Other - Last Name:MULLINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4669 VARSITY CIR
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-2064
Mailing Address - Country:US
Mailing Address - Phone:239-246-2772
Mailing Address - Fax:
Practice Address - Street 1:1169 HOMESTEAD RD N
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6040
Practice Address - Country:US
Practice Address - Phone:239-369-9109
Practice Address - Fax:239-369-4762
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor