Provider Demographics
NPI:1740405547
Name:THOMAS E GAEGIULA, D.C., P.C.
Entity Type:Organization
Organization Name:THOMAS E GAEGIULA, D.C., P.C.
Other - Org Name:WINDMILL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GARGIULA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-849-4120
Mailing Address - Street 1:9717 LANDMARK PARKWAY DR
Mailing Address - Street 2:SUITE 216
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1628
Mailing Address - Country:US
Mailing Address - Phone:314-849-4120
Mailing Address - Fax:314-849-2540
Practice Address - Street 1:9717 LANDMARK PARKWAY DR
Practice Address - Street 2:SUITE 216
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1628
Practice Address - Country:US
Practice Address - Phone:314-849-4120
Practice Address - Fax:314-849-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty