Provider Demographics
NPI:1861113912
Name:GAGE CHIROPRACTIC CLINICS LLC
Entity type:Organization
Organization Name:GAGE CHIROPRACTIC CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-677-8387
Mailing Address - Street 1:128 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5229
Mailing Address - Country:US
Mailing Address - Phone:304-677-8387
Mailing Address - Fax:
Practice Address - Street 1:12186 HIGHWAY 92 STE B111
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-5105
Practice Address - Country:US
Practice Address - Phone:304-677-8387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center