Provider Demographics
NPI:1033830849
Name:GABE ARICIU DC LLC
Entity Type:Organization
Organization Name:GABE ARICIU DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ARICIU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-631-3152
Mailing Address - Street 1:728 W STATE HIGHWAY 174 APT 3
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-1023
Mailing Address - Country:US
Mailing Address - Phone:417-631-3152
Mailing Address - Fax:
Practice Address - Street 1:1736 E SUNSHINE ST STE 213
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1328
Practice Address - Country:US
Practice Address - Phone:417-631-3152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-09
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty