Healthcare Provider Details

I. General information

NPI: 1285819128
Provider Name (Legal Business Name): VIKKI L TALANCA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625B HARTER AVE
NESCOPECK PA
18635-1310
US

IV. Provider business mailing address

625B HARTER AVE
NESCOPECK PA
18635-1310
US

V. Phone/Fax

Practice location:
  • Phone: 570-204-3345
  • Fax:
Mailing address:
  • Phone: 570-204-3345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC008029
License Number StatePA

VIII. Authorized Official

Name: DR. VIKKI LOUISE TALANCA
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 570-204-3345