A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Chiropractor |
111N00000X | 35 | Chiropractic | |
Orthopaedic Surgery |
207X00000X | 02 | Physician/General Surgery |
| NPI Number | 1376680124 |
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| LBN Legal business name | WESTSIDE PREMIER MED GRP | ||||||||||||
| Authorized official | KIM AMMERMAN - (ADMINISTRATOR) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 01/31/2007 | ||||||||||||
| Last updated | 09/11/2025 - About 9 months ago | ||||||||||||
| Identifiers |
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WESTSIDE PREMIER MED GRP
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