Provider Demographics
NPI:1396820924
Name:ADVANCED CARE CENTER, INC.
Entity Type:Organization
Organization Name:ADVANCED CARE CENTER, INC.
Other - Org Name:ADVANCED NECK AND BACK CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GERADS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-341-4826
Mailing Address - Street 1:2516 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-5201
Mailing Address - Country:US
Mailing Address - Phone:715-341-4826
Mailing Address - Fax:715-341-5080
Practice Address - Street 1:2516 CHURCH ST
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-5201
Practice Address - Country:US
Practice Address - Phone:715-341-4826
Practice Address - Fax:715-341-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty