Provider Demographics
NPI:1598980930
Name:PATIENTS CLINIC INC
Entity Type:Organization
Organization Name:PATIENTS CLINIC INC
Other - Org Name:CHIROPRACTIC CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-308-0250
Mailing Address - Street 1:9414 RIDGETOP BLVD
Mailing Address - Street 2:101
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8526
Mailing Address - Country:US
Mailing Address - Phone:360-308-0250
Mailing Address - Fax:
Practice Address - Street 1:9414 RIDGETOP BLVD
Practice Address - Street 2:101
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8526
Practice Address - Country:US
Practice Address - Phone:360-308-0250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8851931Medicare PIN