Individual
NICOLE MARIE WILBRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
51060 HAYES RD, MACOMB TOWNSHIP, MI 48042-4057
(586) 781-4314
(586) 781-4452
Mailing address
51060 HAYES RD, MACOMB TOWNSHIP, MI 48042-4057
(586) 781-4314
(586) 781-4452
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007696
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95OEO53070
BLUE CROSS BLUE SHIELD
MI
01
—
P115498
BLUE CARE NETWORK
MI
Enumeration date
01/10/2006
Last updated
12/29/2010
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