Provider Demographics
NPI:1912086232
Name:WOLFF, MICHAEL ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:WOLFF
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 1:6401 HIXSON PIKE STE D
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-5725
Mailing Address - Country:US
Mailing Address - Phone:423-842-2435
Mailing Address - Fax:423-842-2444
Practice Address - Street 1:6401 HIXSON PIKE STE D
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-5725
Practice Address - Country:US
Practice Address - Phone:423-842-2435
Practice Address - Fax:423-842-2444
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3672525Medicare ID - Type UnspecifiedMEDICARE ID