Provider Demographics
NPI:1164505269
Name:VOLPERT, ADRIENNE SUE (DC QME)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:SUE
Last Name:VOLPERT
Suffix:
Gender:F
Credentials:DC QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9108 LAGUNA MAIN ST
Mailing Address - Street 2:STE. 1A
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7450
Mailing Address - Country:US
Mailing Address - Phone:916-691-9500
Mailing Address - Fax:916-691-9503
Practice Address - Street 1:9108 LAGUNA MAIN ST
Practice Address - Street 2:STE. 1A
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7450
Practice Address - Country:US
Practice Address - Phone:916-691-9500
Practice Address - Fax:916-691-9503
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 17543111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0175430Medicare UPIN