Provider Demographics
NPI:1548843782
Name:WIREMAN, AMBER DANIELLE-GENNERO (DC)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:DANIELLE-GENNERO
Last Name:WIREMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:DANIELLE
Other - Last Name:GENNERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:41601 TARRAGON DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314
Mailing Address - Country:US
Mailing Address - Phone:248-629-6071
Mailing Address - Fax:
Practice Address - Street 1:23334 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-3102
Practice Address - Country:US
Practice Address - Phone:248-477-5202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05076111N00000X
MI2301010983111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor