Provider Demographics
NPI:1144918673
Name:PREMIER UPPER CERVICAL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:PREMIER UPPER CERVICAL CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:STATNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:925-895-2004
Mailing Address - Street 1:1059 STATE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4269
Mailing Address - Country:US
Mailing Address - Phone:360-363-4498
Mailing Address - Fax:360-322-6103
Practice Address - Street 1:1059 STATE AVE STE A
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4269
Practice Address - Country:US
Practice Address - Phone:360-363-4498
Practice Address - Fax:360-322-6103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty