Provider Demographics
NPI:1376620708
Name:EHLERS, ROBERT WESTON (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WESTON
Last Name:EHLERS
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 1:673A MERCHANT ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-6907
Mailing Address - Country:US
Mailing Address - Phone:707-446-0700
Mailing Address - Fax:707-447-0800
Practice Address - Street 1:673A MERCHANT ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-6907
Practice Address - Country:US
Practice Address - Phone:707-446-0700
Practice Address - Fax:707-447-0800
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0280640Medicare ID - Type Unspecified