Provider Demographics
NPI:1871573998
Name:VECCHIONI, WILLIAM D (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:VECCHIONI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4218 PELHAM
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-3121
Mailing Address - Country:US
Mailing Address - Phone:313-277-1100
Mailing Address - Fax:313-277-5787
Practice Address - Street 1:4218 PELHAM
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48125-3121
Practice Address - Country:US
Practice Address - Phone:313-277-1100
Practice Address - Fax:313-277-5787
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0Q25074OtherBLUE CROSS BLUE SHIELD
MI0Q25074OtherBLUE CROSS BLUE SHIELD
T33833Medicare UPIN