Provider Demographics
NPI:1497085070
Name:GONNERMAN CHIROPRACTIC & ACUPUNCTURE PC
Entity Type:Organization
Organization Name:GONNERMAN CHIROPRACTIC & ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GONNERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-332-2755
Mailing Address - Street 1:405 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:IA
Mailing Address - Zip Code:50548-1728
Mailing Address - Country:US
Mailing Address - Phone:515-332-2755
Mailing Address - Fax:
Practice Address - Street 1:405 SUMNER AVE STE A
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:IA
Practice Address - Zip Code:50548-1756
Practice Address - Country:US
Practice Address - Phone:515-332-2755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty