Provider Demographics
NPI:1851553184
Name:CHAMBERLIN, GAYLE LEE (DC BS)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:LEE
Last Name:CHAMBERLIN
Suffix:
Gender:M
Credentials:DC BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6942 HIGHLAND CIR NW
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-9708
Mailing Address - Country:US
Mailing Address - Phone:320-846-9988
Mailing Address - Fax:
Practice Address - Street 1:6942 HIGHLAND CIR NW
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-9708
Practice Address - Country:US
Practice Address - Phone:320-846-9988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN003367111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor