Individual
MICHAEL S PANKOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2000 GENERAL BOOTH BLVD, VIRGINIA BEACH, VA 23454-5876
(757) 490-0990
Mailing address
2000 GENERAL BOOTH BLVD, VIRGINIA BEACH, VA 23454-5876
(757) 490-0990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104000747
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059152
BCBS
VA
Enumeration date
09/14/2005
Last updated
03/12/2012
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