Provider Demographics
NPI:1740790716
Name:ARICIU, GABRIEL J (DC)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:J
Last Name:ARICIU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 W STATE HIGHWAY 174 APT 3
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-1023
Mailing Address - Country:US
Mailing Address - Phone:417-631-3152
Mailing Address - Fax:
Practice Address - Street 1:1736 E SUNSHINE ST STE 213
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1328
Practice Address - Country:US
Practice Address - Phone:417-631-3152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017031982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty