Healthcare Provider Details
I. General information
NPI: 1659109247
Provider Name (Legal Business Name): EHRESMAN FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/24/2024
Last Update Date: 07/24/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23160 NE STATE HWY 3
BELFAIR WA
98525-1267
US
IV. Provider business mailing address
PO BOX 1267
BELFAIR WA
98528-1267
US
V. Phone/Fax
- Phone: 360-275-4401
- Fax: 360-275-8016
- Phone: 360-275-4401
- Fax: 360-275-8016
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KIMBERLY
EHRESMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 360-275-4401