Provider Demographics
NPI:1174668552
Name:NEWTON, GARY LEE (DC)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:LEE
Last Name:NEWTON
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 1:1058 LEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-4133
Mailing Address - Country:US
Mailing Address - Phone:408-998-1228
Mailing Address - Fax:408-998-2850
Practice Address - Street 1:1058 LEIGH AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-4133
Practice Address - Country:US
Practice Address - Phone:408-998-1228
Practice Address - Fax:408-998-2850
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor