Healthcare Provider Details

I. General information

NPI: 1881032019
Provider Name (Legal Business Name): WOLKE CHIROPRACTIC & REHABILITATION, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2013
Last Update Date: 06/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 POMPTON AVE
VERONA NJ
07044-2942
US

IV. Provider business mailing address

155 POMPTON AVE
VERONA NJ
07044-2942
US

V. Phone/Fax

Practice location:
  • Phone: 973-433-7204
  • Fax: 973-433-7208
Mailing address:
  • Phone: 973-433-7204
  • Fax: 973-433-7208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY WOLKE
Title or Position: DOCTOR/ OWNER
Credential: D.C.
Phone: 973-433-7204