Provider Demographics
NPI:1508854779
Name:SOLLEY, GEORGE DANEKER (DC)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:DANEKER
Last Name:SOLLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-5317
Mailing Address - Country:US
Mailing Address - Phone:570-322-2225
Mailing Address - Fax:
Practice Address - Street 1:580 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5317
Practice Address - Country:US
Practice Address - Phone:570-322-2225
Practice Address - Fax:570-322-2766
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005921-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA569356Q0VMedicare UPIN