Provider Demographics
NPI:1790118719
Name:VLCEK, NICOLE L (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:L
Last Name:VLCEK
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 1:711 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66092-8725
Mailing Address - Country:US
Mailing Address - Phone:785-883-2234
Mailing Address - Fax:785-883-2244
Practice Address - Street 1:711 MAIN ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:KS
Practice Address - Zip Code:66092-8725
Practice Address - Country:US
Practice Address - Phone:785-883-2234
Practice Address - Fax:785-883-2244
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor