Individual
GERARD P POORTINGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
525 DAYTON ST, YELLOW SPRINGS, OH 45387-1709
(937) 767-1115
(937) 767-9997
Mailing address
525 DAYTON ST, YELLOW SPRINGS, OH 45387-1709
(937) 767-1115
(937) 767-9997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
764
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0450211
—
OH
Enumeration date
03/16/2007
Last updated
07/08/2007
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