Provider Demographics
NPI:1144235680
Name:FONKE, VICTORIA GODWIN (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:GODWIN
Last Name:FONKE
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 1:1623 YORK AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-2355
Mailing Address - Country:US
Mailing Address - Phone:336-882-2434
Mailing Address - Fax:336-882-4747
Practice Address - Street 1:1623 YORK AVE STE 101
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-2355
Practice Address - Country:US
Practice Address - Phone:336-882-2434
Practice Address - Fax:336-882-4747
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor