Provider Demographics
NPI:1679831002
Name:HEMMELMAN CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:HEMMELMAN CHIROPRACTIC, PC
Other - Org Name:WOODLAND CHIROPRACTIC WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEMMELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-608-1666
Mailing Address - Street 1:1933 BELMONT LOOP
Mailing Address - Street 2:SUITE C
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-8492
Mailing Address - Country:US
Mailing Address - Phone:360-225-5726
Mailing Address - Fax:360-225-2253
Practice Address - Street 1:1933 BELMONT LOOP
Practice Address - Street 2:SUITE C
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-8492
Practice Address - Country:US
Practice Address - Phone:360-225-5726
Practice Address - Fax:360-225-2253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty