Provider Demographics
NPI:1134227929
Name:SAKS, GARY C (DC)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:C
Last Name:SAKS
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 1:1447 S OTSEGO AVE
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-7739
Mailing Address - Country:US
Mailing Address - Phone:989-732-7000
Mailing Address - Fax:989-732-4271
Practice Address - Street 1:1447 S OTSEGO AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-7739
Practice Address - Country:US
Practice Address - Phone:989-732-7000
Practice Address - Fax:989-732-4271
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIGS002807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950F910220OtherBLUE CROSS BLUE SHIELD
MI950F910220OtherBLUE CROSS BLUE SHIELD
MIT33495Medicare UPIN