Gonzales, Antonio Ray

Gonzales, Antonio Ray is an individual health care provider with primary practice located at 920 Lambert St , Niles MI 49120-3413. He recently has 3 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Rehabilitation, Chiropractic Providers / Nutrition. Chiropractic Providers / Rehabilitation is his primary health care specialty. Gonzales, Antonio Ray can be contacted via phone (269) 684-4200.

Contact Information

Primary practice address
920 Lambert St Niles MI 49120-3413
Phone: (269) 684-4200
Fax: (269) 262-0943
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 08001868A Indiana
Chiropractic Providers / Rehabilitation 111NR0400X 2301008841 Michigan
Chiropractic Providers / Nutrition 111NN1001X 2301008841 Michigan
Chiropractic Providers / Chiropractor 111N00000X 2301008841 Michigan

Profile Details

NPI number 1679600829
LBN Legal business name Gonzales, Antonio Ray
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated Nov 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679600829 NPPES
Indiana MEDICAID 200258400

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