Healthcare Provider Details

I. General information

NPI: 1609872464
Provider Name (Legal Business Name): ROBERT GABRIEL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 N STATE ST
CARO MI
48723-1546
US

IV. Provider business mailing address

758 N STATE ST
CARO MI
48723-1546
US

V. Phone/Fax

Practice location:
  • Phone: 989-672-4141
  • Fax: 989-672-4040
Mailing address:
  • Phone: 989-672-4141
  • Fax: 989-672-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301007693
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: