Provider Demographics
NPI:1528042421
Name:WOLFE, BILL BYRON (DC)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:BYRON
Last Name:WOLFE
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 1:150 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-1515
Mailing Address - Country:US
Mailing Address - Phone:610-683-3188
Mailing Address - Fax:
Practice Address - Street 1:150 E MAIN ST
Practice Address - Street 2:
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530-1515
Practice Address - Country:US
Practice Address - Phone:610-683-3188
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 002141 L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA087655Medicare ID - Type Unspecified