Provider Demographics
NPI:1497822431
Name:WALKO CHIROPRACTIC AND NUTRITION PC
Entity Type:Organization
Organization Name:WALKO CHIROPRACTIC AND NUTRITION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZY
Authorized Official - Middle Name:
Authorized Official - Last Name:STRUMWASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-540-4000
Mailing Address - Street 1:69 DAVIS STRAITS
Mailing Address - Street 2:RT 28
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540
Mailing Address - Country:US
Mailing Address - Phone:508-540-4000
Mailing Address - Fax:508-540-5151
Practice Address - Street 1:69 DAVIS STRAITS
Practice Address - Street 2:RT 28
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:508-540-4000
Practice Address - Fax:508-540-5151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA1776 & MA1808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y39124Medicare ID - Type Unspecified