Provider Demographics
NPI:1952556268
Name:GILBERT CHIROPRACTIC CLINIC, INC.
Entity Type:Organization
Organization Name:GILBERT CHIROPRACTIC CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:K
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-794-3344
Mailing Address - Street 1:2109 60TH ST W STE B
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5526
Mailing Address - Country:US
Mailing Address - Phone:941-794-3344
Mailing Address - Fax:941-794-8057
Practice Address - Street 1:2109 60TH ST W STE B
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5526
Practice Address - Country:US
Practice Address - Phone:941-794-3344
Practice Address - Fax:941-794-8057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7101111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty