Provider Demographics
NPI:1154382257
Name:FLOOK, WILLIAM RAY (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RAY
Last Name:FLOOK
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 1:1843 HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-1311
Mailing Address - Country:US
Mailing Address - Phone:570-759-0145
Mailing Address - Fax:
Practice Address - Street 1:309 E FRONT ST
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-4811
Practice Address - Country:US
Practice Address - Phone:570-752-2989
Practice Address - Fax:570-759-0646
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001333L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29046Medicare UPIN
PAFL115801Medicare ID - Type Unspecified