Provider Demographics
NPI:1417007246
Name:VIEREGGE, ADELINE MAE (DC)
Entity Type:Individual
Prefix:
First Name:ADELINE
Middle Name:MAE
Last Name:VIEREGGE
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 1:237 W MAIN ST
Mailing Address - Street 2:PO BOX 1266
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-1560
Mailing Address - Country:US
Mailing Address - Phone:814-445-7000
Mailing Address - Fax:
Practice Address - Street 1:237 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1560
Practice Address - Country:US
Practice Address - Phone:814-445-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001458L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAVI070579Medicare ID - Type UnspecifiedCHIROPRACTIC