Provider Demographics
NPI:1245327147
Name:VALKOS, DAVID F (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:VALKOS
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 1:106 SO WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55041
Mailing Address - Country:US
Mailing Address - Phone:651-345-2785
Mailing Address - Fax:
Practice Address - Street 1:106 SO WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:MN
Practice Address - Zip Code:55041
Practice Address - Country:US
Practice Address - Phone:651-345-2785
Practice Address - Fax:651-345-5321
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN002300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5668059OtherAETNA
MN5966OVAOtherBCBS
GA350053075OtherMCRAILROAD
MN603584OtherCCMI
WI90144935OtherWAUSAU
MN381328200Medicaid
WI90144935OtherWAUSAU
MN350000383Medicare ID - Type Unspecified