Provider Demographics
NPI:1194973644
Name:GAMERDINGER JEFFERS, AMY (DC)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:GAMERDINGER JEFFERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-2404
Mailing Address - Country:US
Mailing Address - Phone:715-720-2887
Mailing Address - Fax:715-720-2304
Practice Address - Street 1:2889 COUNTY HIGHWAY I
Practice Address - Street 2:SUITE 2
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-4300
Practice Address - Country:US
Practice Address - Phone:715-720-2887
Practice Address - Fax:715-720-2304
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4436-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38188000Medicaid