Provider Demographics
NPI:1215144167
Name:HARIG, GRETCHEN ANN (DC)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:ANN
Last Name:HARIG
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 1:1235 N DUTTON AVE
Mailing Address - Street 2:SUITE: D
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4642
Mailing Address - Country:US
Mailing Address - Phone:707-546-3546
Mailing Address - Fax:707-546-9826
Practice Address - Street 1:1235 N DUTTON AVE
Practice Address - Street 2:SUITE: D
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4642
Practice Address - Country:US
Practice Address - Phone:707-546-9822
Practice Address - Fax:707-546-9826
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor