Provider Demographics
NPI:1659109247
Name:EHRESMAN FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:EHRESMAN FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:EHRESMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-275-4401
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:BELFAIR
Mailing Address - State:WA
Mailing Address - Zip Code:98528-1267
Mailing Address - Country:US
Mailing Address - Phone:360-275-4401
Mailing Address - Fax:360-275-8016
Practice Address - Street 1:23160 NE STATE HWY 3
Practice Address - Street 2:
Practice Address - City:BELFAIR
Practice Address - State:WA
Practice Address - Zip Code:98525-1267
Practice Address - Country:US
Practice Address - Phone:360-275-4401
Practice Address - Fax:360-275-8016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty