Provider Demographics
NPI:1205234614
Name:WEATHERLEY, DEVIN (DC)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:WEATHERLEY
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 1:2648 FM 407 E STE 145
Mailing Address - Street 2:
Mailing Address - City:BARTONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-7008
Mailing Address - Country:US
Mailing Address - Phone:214-215-5135
Mailing Address - Fax:
Practice Address - Street 1:2648 FM 407 E STE 145
Practice Address - Street 2:
Practice Address - City:BARTONVILLE
Practice Address - State:TX
Practice Address - Zip Code:76226-7008
Practice Address - Country:US
Practice Address - Phone:214-215-5135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33143111N00000X
TX14330111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor