Provider Demographics
NPI:1871756502
Name:WHALEY, LINDSAY MARIE (DC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:WHALEY
Suffix:
Gender:F
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:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:NIAGARA
Mailing Address - State:WI
Mailing Address - Zip Code:54151-0193
Mailing Address - Country:US
Mailing Address - Phone:715-251-4020
Mailing Address - Fax:
Practice Address - Street 1:621 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA
Practice Address - State:WI
Practice Address - Zip Code:54151-1213
Practice Address - Country:US
Practice Address - Phone:715-251-4020
Practice Address - Fax:715-251-0772
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009435111N00000X
WI5084-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor