Provider Demographics
NPI:1942593595
Name:CALEB GATES LLC
Entity Type:Organization
Organization Name:CALEB GATES LLC
Other - Org Name:ACUPUNCTURE AND ADVACNED ALLERGY RELIEF CENTER OF THE SOUTHWEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:GATES
Authorized Official - Suffix:III
Authorized Official - Credentials:LAC
Authorized Official - Phone:970-259-9488
Mailing Address - Street 1:1199 MAIN AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5171
Mailing Address - Country:US
Mailing Address - Phone:970-259-9488
Mailing Address - Fax:979-259-9488
Practice Address - Street 1:1199 MAIN AVE STE 230
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5171
Practice Address - Country:US
Practice Address - Phone:970-259-9488
Practice Address - Fax:970-259-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO967171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty