Healthcare Provider Details

I. General information

NPI: 1952556268
Provider Name (Legal Business Name): GILBERT CHIROPRACTIC CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 60TH ST W STE B
BRADENTON FL
34209-5526
US

IV. Provider business mailing address

2109 60TH ST W STE B
BRADENTON FL
34209-5526
US

V. Phone/Fax

Practice location:
  • Phone: 941-794-3344
  • Fax: 941-794-8057
Mailing address:
  • Phone: 941-794-3344
  • Fax: 941-794-8057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH7101
License Number StateFL

VIII. Authorized Official

Name: DR. RONALD K. GILBERT
Title or Position: PRESIDENT
Credential: DC
Phone: 941-794-3344