Individual
DR. THEODORE J. POELKING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2660 WOODMAN CENTER CT, DAYTON, OH 45420-1477
(937) 299-2900
Mailing address
8648 CYPRESS TRL, WAYNESVILLE, OH 45068-8361
(937) 885-6110
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2199
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128301
—
OH
01
—
PO9280591
MEDICARE GROUP
OH
Enumeration date
10/12/2006
Last updated
05/10/2016
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