Provider Demographics
NPI:1518260827
Name:GABRIEL, ARTHUR JOHN (LAT)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:JOHN
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 N. LUCRETIA STREET
Mailing Address - Street 2:JOHNSON CENTER
Mailing Address - City:OAKLAND CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47660
Mailing Address - Country:US
Mailing Address - Phone:812-746-1262
Mailing Address - Fax:812-746-1262
Practice Address - Street 1:138 N LUCRETIA ST
Practice Address - Street 2:JOHNSON CENTER
Practice Address - City:OAKLAND CITY
Practice Address - State:IN
Practice Address - Zip Code:47660-1038
Practice Address - Country:US
Practice Address - Phone:812-746-1262
Practice Address - Fax:812-746-1262
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001651A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer