Provider Demographics
NPI:1720185739
Name:GAMET CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:GAMET CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:W
Authorized Official - Last Name:GAMET
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-799-2020
Mailing Address - Street 1:6022 HARVEY ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-8802
Mailing Address - Country:US
Mailing Address - Phone:231-799-2020
Mailing Address - Fax:231-799-9666
Practice Address - Street 1:6022 HARVEY ST
Practice Address - Street 2:SUITE G
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-8802
Practice Address - Country:US
Practice Address - Phone:231-799-2020
Practice Address - Fax:231-799-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI008467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N71780Medicare PIN