Wolf Specific, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

CHIR008690 Issued in GA

Legal business name

WOLF SPECIFIC, INC

Practice address

1697 Vernon Rd Ste a
Lagrange, GA 30240-4180

Phone

(706) 415-5245

NPI assigned

Mar 29, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Matthew Tyler Wolfertz, D.C.NPI 1760798128

Title

President

Phone

(706) 756-5422

Specialties & licenses 1

Addresses

Other names 1

• The Upper Cervical Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Tyler Wolfertz, D.C.

  • Chiropractor
  • Lagrange, GA
  • NPI 1760798128
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1013283563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1697 VERNON RD STE A",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404180",
            "telephone_number": "706-415-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1697 VERNON RD STE A",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404180",
            "telephone_number": "706-415-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF SPECIFIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "WOLFERTZ",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-756-5422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "CHIR008690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Upper Cervical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda Willoughby, RPH.
• Kenleeanne Hass Wilson, DMD
• Robin Wilson, LPN
• Joni Lee Winter, FNP
• Deena Renae Wise, D.O.
• Matthew Tyler Wolfertz, D.C.
• Candace H Wortham, CFNP
• Chiquita Yvette Wright
• James L Yancey
• Brandy Leigh Yarbrough, N.P.

• Clinic/Center in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.