Provider Demographics
NPI:1639400872
Name:WOLFF CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:WOLFF CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WOLFF
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:423-842-2435
Mailing Address - Street 1:6401 HIXSON PIKE, SUITE D
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343
Mailing Address - Country:US
Mailing Address - Phone:423-842-2435
Mailing Address - Fax:423-842-2444
Practice Address - Street 1:6401 HIXSON PIKE, SUITE D
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343
Practice Address - Country:US
Practice Address - Phone:423-842-2435
Practice Address - Fax:423-842-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0145808OtherBLUE CROSS/BLUE SHIELD OF TN
TN3672525Medicare PIN