Healthcare Provider Details

I. General information

NPI: 1366957144
Provider Name (Legal Business Name): CANDACE C GORGES DC. MS.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2017
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 N MAIN ST STE I
FRANKENMUTH MI
48734-1046
US

IV. Provider business mailing address

975 N MAIN ST STE I
FRANKENMUTH MI
48734-1046
US

V. Phone/Fax

Practice location:
  • Phone: 636-236-9241
  • Fax:
Mailing address:
  • Phone: 636-236-9241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2301010596
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2017030082
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010596
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: