Provider Demographics
NPI:1285819128
Name:VIKKI L TALANCA
Entity Type:Organization
Organization Name:VIKKI L TALANCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKKI
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:TALANCA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-204-3345
Mailing Address - Street 1:625B HARTER AVE
Mailing Address - Street 2:
Mailing Address - City:NESCOPECK
Mailing Address - State:PA
Mailing Address - Zip Code:18635-1310
Mailing Address - Country:US
Mailing Address - Phone:570-204-3345
Mailing Address - Fax:
Practice Address - Street 1:625B HARTER AVE
Practice Address - Street 2:
Practice Address - City:NESCOPECK
Practice Address - State:PA
Practice Address - Zip Code:18635-1310
Practice Address - Country:US
Practice Address - Phone:570-204-3345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA057971OtherMEDICARE
PAU90200Medicare UPIN