Provider Demographics
NPI:1851720957
Name:WULF, ANGELA (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:WULF
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 1:235 N OAK LN
Mailing Address - Street 2:PO BOX 485
Mailing Address - City:BLUE GRASS
Mailing Address - State:IA
Mailing Address - Zip Code:52726-7706
Mailing Address - Country:US
Mailing Address - Phone:989-240-7133
Mailing Address - Fax:
Practice Address - Street 1:235 N OAK LN
Practice Address - Street 2:
Practice Address - City:BLUE GRASS
Practice Address - State:IA
Practice Address - Zip Code:52726-7706
Practice Address - Country:US
Practice Address - Phone:989-240-7133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor