Provider Demographics
NPI:1235208661
Name:COOLS, GARY SCOTT (ND)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:SCOTT
Last Name:COOLS
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-0665
Mailing Address - Country:US
Mailing Address - Phone:231-845-1250
Mailing Address - Fax:231-845-1250
Practice Address - Street 1:414 W US HIGHWAY 10 31
Practice Address - Street 2:
Practice Address - City:SCOTTVILLE
Practice Address - State:MI
Practice Address - Zip Code:49454-9274
Practice Address - Country:US
Practice Address - Phone:231-845-1250
Practice Address - Fax:231-845-1250
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X, 171100000X
FL247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No171100000XOther Service ProvidersAcupuncturist