Healthcare Provider Details

I. General information

NPI: 1962571836
Provider Name (Legal Business Name): ANTHONY WOLKE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 HIGH MOUNTAIN RD
NORTH HALEDON NJ
07508-2665
US

IV. Provider business mailing address

535 HIGH MOUNTAIN RD
NORTH HALEDON NJ
07508-2665
US

V. Phone/Fax

Practice location:
  • Phone: 973-423-9001
  • Fax: 973-423-5525
Mailing address:
  • Phone: 973-423-9001
  • Fax: 973-423-5525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00603900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: