Provider Demographics
NPI:1861432643
Name:GAUS, DANA MARIE (DC, CCN)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:GAUS
Suffix:
Gender:F
Credentials:DC, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 SUTTON PARK CT
Mailing Address - Street 2:SUITE 504
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-0250
Mailing Address - Country:US
Mailing Address - Phone:904-992-0100
Mailing Address - Fax:904-992-0111
Practice Address - Street 1:4745 SUTTON PARK CT
Practice Address - Street 2:SUITE 504
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-0250
Practice Address - Country:US
Practice Address - Phone:904-992-0100
Practice Address - Fax:904-992-0111
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7831111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55942OtherBCBS
FLP00071025OtherRAILROAD MEDICARE
FL55942Medicare ID - Type Unspecified
FLU81641Medicare UPIN