Provider Demographics
NPI:1881752343
Name:LIFE FORCE CHIROPRACTIC OF POULSBO INC
Entity type:Organization
Organization Name:LIFE FORCE CHIROPRACTIC OF POULSBO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-620-6026
Mailing Address - Street 1:1016 NE FOREST ROCK LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-9040
Mailing Address - Country:US
Mailing Address - Phone:360-779-5580
Mailing Address - Fax:360-779-2253
Practice Address - Street 1:1016 NE FOREST ROCK LN
Practice Address - Street 2:SUITE 105
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-9040
Practice Address - Country:US
Practice Address - Phone:360-779-5580
Practice Address - Fax:360-779-2253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty