Provider Demographics
NPI:1174761548
Name:GEORGE VOELKL CHIROPRACTOR
Entity type:Organization
Organization Name:GEORGE VOELKL CHIROPRACTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VOELKL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-671-6930
Mailing Address - Street 1:1680 EMPIRE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2130
Mailing Address - Country:US
Mailing Address - Phone:585-671-6930
Mailing Address - Fax:585-787-1957
Practice Address - Street 1:1680 EMPIRE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2130
Practice Address - Country:US
Practice Address - Phone:585-671-6930
Practice Address - Fax:585-787-1957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA4218Medicare PIN
NYBA0300Medicare PIN