Provider Demographics
NPI:1306043138
Name:GILBERT CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:GILBERT CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:W.
Authorized Official - Middle Name:VANCE
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:864-472-2871
Mailing Address - Street 1:11736 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-1810
Mailing Address - Country:US
Mailing Address - Phone:864-472-2871
Mailing Address - Fax:864-472-2235
Practice Address - Street 1:11736 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:SC
Practice Address - Zip Code:29349-1810
Practice Address - Country:US
Practice Address - Phone:864-472-2871
Practice Address - Fax:864-472-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT663369025Medicare UPIN
SCT66336Medicare UPIN
SC9025Medicare PIN