Provider Demographics
NPI:1780655357
Name:VOLK, DAVID J (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:VOLK
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 1:220 E RACINE ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:WI
Mailing Address - Zip Code:53549-1607
Mailing Address - Country:US
Mailing Address - Phone:920-674-6108
Mailing Address - Fax:920-674-3771
Practice Address - Street 1:220 E RACINE ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:WI
Practice Address - Zip Code:53549-1607
Practice Address - Country:US
Practice Address - Phone:920-674-6108
Practice Address - Fax:920-674-3771
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI00135868Medicare PIN