MEDICARE: DR. GREGORY RAYMOND GUMBERICH DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH2848	FL

General Provider Information

NPI Number	:	1285713388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY RAYMOND GUMBERICH DC

Provider Business Mailing Address
First Line	:	6426 LAKE WORTH ROAD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-3008
Country	:	US
Telephone Number	:	561-964-1600
Fax Number	:	561-964-5404

Provider Business Practice Location Address
First Line	:	6426 LAKE WORTH ROAD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-3008
Country	:	US
Telephone Number	:	561-964-1600
Fax Number	:	561-964-5404

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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