MEDICARE: DR. ALAN EDWARD WOLKOW DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	002121	GA

General Provider Information

NPI Number	:	1932143849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN EDWARD WOLKOW DC

Provider Business Mailing Address
First Line	:	3499 DULUTH PARK LN
Second Line	:	STE 110
City	:	DULUTH
State	:	GA
Zip	:	30096-3259
Country	:	US
Telephone Number	:	770-623-9291
Fax Number	:	770-623-1308

Provider Business Practice Location Address
First Line	:	3499 DULUTH PARK LN
Second Line	:	STE 110
City	:	DULUTH
State	:	GA
Zip	:	30096-3259
Country	:	US
Telephone Number	:	770-623-9291
Fax Number	:	770-623-1308

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/08/2007

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