Provider Demographics
NPI:1346514064
Name:GATOR ONE INVESTMENTS INC.
Entity Type:Organization
Organization Name:GATOR ONE INVESTMENTS INC.
Other - Org Name:ELITE GYM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCNABB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:903-984-5522
Mailing Address - Street 1:120 JOHNSTON ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-3909
Mailing Address - Country:US
Mailing Address - Phone:903-753-2020
Mailing Address - Fax:
Practice Address - Street 1:120 JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-3909
Practice Address - Country:US
Practice Address - Phone:903-753-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty