Provider Demographics
NPI:1053599894
Name:GENTLE CARE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:GENTLE CARE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:EZAGUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-650-2394
Mailing Address - Street 1:21860 WILLAMETTE DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3256
Mailing Address - Country:US
Mailing Address - Phone:503-650-2394
Mailing Address - Fax:
Practice Address - Street 1:21860 WILLAMETTE DR
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3256
Practice Address - Country:US
Practice Address - Phone:503-650-2394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty