Provider Demographics
NPI:1629219183
Name:NIEKAMP, ERIN GINA (DC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:GINA
Last Name:NIEKAMP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:GINA
Other - Last Name:WEITZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 BEAR DR
Mailing Address - Street 2:
Mailing Address - City:NEW BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:45869-1001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:551 S. EASTERN AVE
Practice Address - Street 2:
Practice Address - City:ST. HENRY
Practice Address - State:OH
Practice Address - Zip Code:45883
Practice Address - Country:US
Practice Address - Phone:419-305-7245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor