Provider Demographics
NPI:1487986550
Name:KOERBER, GERD (DC)
Entity type:Individual
Prefix:DR
First Name:GERD
Middle Name:
Last Name:KOERBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 JEFFERSON DAVIS HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5299
Mailing Address - Country:US
Mailing Address - Phone:540-446-5824
Mailing Address - Fax:540-446-5483
Practice Address - Street 1:1995 JEFFERSON DAVIS HWY
Practice Address - Street 2:STE 100
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5299
Practice Address - Country:US
Practice Address - Phone:540-446-5824
Practice Address - Fax:540-446-5483
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor