Provider Demographics
NPI:1760016646
Name:CRUZ GONZALEZ, JULIO CESAR (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:CESAR
Last Name:CRUZ GONZALEZ
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 1:2449 INISHMORE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-2298
Mailing Address - Country:US
Mailing Address - Phone:817-903-7362
Mailing Address - Fax:
Practice Address - Street 1:7333 ROCKVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-3069
Practice Address - Country:US
Practice Address - Phone:317-316-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-28
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003155A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty