Provider Demographics
NPI:1942303011
Name:GERSBACH, KAMMERON ELSKE (DC)
Entity Type:Individual
Prefix:DR
First Name:KAMMERON
Middle Name:ELSKE
Last Name:GERSBACH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 FRONT ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3309
Mailing Address - Country:US
Mailing Address - Phone:406-443-3899
Mailing Address - Fax:406-443-2962
Practice Address - Street 1:830 FRONT ST
Practice Address - Street 2:SUITE B
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3309
Practice Address - Country:US
Practice Address - Phone:406-443-3899
Practice Address - Fax:406-443-2962
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1129111N00000X
CADC29465111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor