Individual
WESLEY F HEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1355 E CENTER ST, POCATELLO, ID 83201-4737
(208) 238-9355
(208) 233-1200
Mailing address
1355 E CENTER ST, POCATELLO, ID 83201-4737
(208) 238-9355
(208) 233-1200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1258
ID
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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