Provider Demographics
NPI:1609292663
Name:CATHERINE E. WACKERLY, D.C., PLLC
Entity type:Organization
Organization Name:CATHERINE E. WACKERLY, D.C., PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-667-9700
Mailing Address - Street 1:412 SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-5641
Mailing Address - Country:US
Mailing Address - Phone:989-391-4082
Mailing Address - Fax:
Practice Address - Street 1:412 SAGINAW ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5641
Practice Address - Country:US
Practice Address - Phone:989-391-4082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty