Provider Demographics
NPI:1750330403
Name:TALANCA, VIKKI LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:VIKKI
Middle Name:LOUISE
Last Name:TALANCA
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 1:503 3RD ST
Mailing Address - Street 2:P.O. BOX 41
Mailing Address - City:NESCOPECK
Mailing Address - State:PA
Mailing Address - Zip Code:18635-1136
Mailing Address - Country:US
Mailing Address - Phone:570-752-9100
Mailing Address - Fax:
Practice Address - Street 1:503 3RD ST
Practice Address - Street 2:
Practice Address - City:NESCOPECK
Practice Address - State:PA
Practice Address - Zip Code:18635-1407
Practice Address - Country:US
Practice Address - Phone:570-752-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008029111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA122494Medicare PIN
PAU90200Medicare UPIN