Provider Demographics
NPI:1124278940
Name:JOINTS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:JOINTS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN GANSERT
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:GANSERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-852-2268
Mailing Address - Street 1:147 W ROUTE 66
Mailing Address - Street 2:613
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-6208
Mailing Address - Country:US
Mailing Address - Phone:626-852-2268
Mailing Address - Fax:
Practice Address - Street 1:625 E ARROW HWY
Practice Address - Street 2:1
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-6521
Practice Address - Country:US
Practice Address - Phone:626-852-2268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25567261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25567Medicare UPIN