Provider Demographics
NPI:1114779147
Name:EGERER CHIROPRACTIC INC
Entity Type:Organization
Organization Name:EGERER CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:EGERER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-996-2356
Mailing Address - Street 1:1525 N PLACENTIA AVE STE F
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-2334
Mailing Address - Country:US
Mailing Address - Phone:714-996-2356
Mailing Address - Fax:
Practice Address - Street 1:1525 N PLACENTIA AVE STE F
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-2334
Practice Address - Country:US
Practice Address - Phone:714-996-2356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1649293788OtherNPPES