Provider Demographics
NPI:1588136436
Name:M WHEELER PLLC
Entity type:Organization
Organization Name:M WHEELER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DC
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHAN
Authorized Official - Middle Name:JAYCOB
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-981-0093
Mailing Address - Street 1:3904 E MULLAN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-4009
Mailing Address - Country:US
Mailing Address - Phone:208-981-0093
Mailing Address - Fax:
Practice Address - Street 1:3904 E MULLAN AVE STE C
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-4009
Practice Address - Country:US
Practice Address - Phone:360-789-9180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty