Provider Demographics
NPI:1760425037
Name:VOLLMERS, ALICIA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:MARIE
Last Name:VOLLMERS
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 1:1401 SKYLINE BLVD 240
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1300
Mailing Address - Country:US
Mailing Address - Phone:701-224-9500
Mailing Address - Fax:701-224-9511
Practice Address - Street 1:1401 SKYLINE BLVD 240
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1300
Practice Address - Country:US
Practice Address - Phone:701-224-9500
Practice Address - Fax:701-224-9511
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7604700Medicaid
ND13743Medicaid
SD7604700Medicaid