Provider Demographics
NPI:1083675607
Name:GUTWEIN, ALEX GENE (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:GENE
Last Name:GUTWEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11610 GRABILL RD
Mailing Address - Street 2:
Mailing Address - City:LEO
Mailing Address - State:IN
Mailing Address - Zip Code:46765-9701
Mailing Address - Country:US
Mailing Address - Phone:260-627-8000
Mailing Address - Fax:260-627-8000
Practice Address - Street 1:11610 GRABILL RD
Practice Address - Street 2:
Practice Address - City:LEO
Practice Address - State:IN
Practice Address - Zip Code:46765-9701
Practice Address - Country:US
Practice Address - Phone:260-627-8000
Practice Address - Fax:260-627-8000
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001869A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor