Provider Demographics
NPI:1285839167
Name:RAYMOND GASKEY D.C. P.C.
Entity Type:Organization
Organization Name:RAYMOND GASKEY D.C. P.C.
Other - Org Name:BRADFORD FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-552-7979
Mailing Address - Street 1:3225 SHALLOWFORD RD STE 810
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-7028
Mailing Address - Country:US
Mailing Address - Phone:770-552-7979
Mailing Address - Fax:770-552-1153
Practice Address - Street 1:3225 SHALLOWFORD RD STE 810
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-7028
Practice Address - Country:US
Practice Address - Phone:770-552-7979
Practice Address - Fax:770-552-1153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006197111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty