Provider Demographics
NPI:1326385204
Name:PLOCEK, NOLAN
Entity Type:Individual
Prefix:DR
First Name:NOLAN
Middle Name:
Last Name:PLOCEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 OGDEN RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5683
Mailing Address - Country:US
Mailing Address - Phone:970-252-0378
Mailing Address - Fax:
Practice Address - Street 1:1541 OGDEN RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5683
Practice Address - Country:US
Practice Address - Phone:970-252-0378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6930111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor