Provider Demographics
NPI:1871725168
Name:WOLFF, DUANE ROSS (DC)
Entity type:Individual
Prefix:DR
First Name:DUANE
Middle Name:ROSS
Last Name:WOLFF
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:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:THIEF RIVER FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56701-0387
Mailing Address - Country:US
Mailing Address - Phone:218-681-4574
Mailing Address - Fax:218-681-4594
Practice Address - Street 1:1544 HWY 59 SE
Practice Address - Street 2:
Practice Address - City:THIEF RIVER FALLS
Practice Address - State:MN
Practice Address - Zip Code:56701
Practice Address - Country:US
Practice Address - Phone:218-681-4574
Practice Address - Fax:218-681-4594
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor