Provider Demographics
NPI:1356358667
Name:GAIL, AUBREY C (DC)
Entity type:Individual
Prefix:DR
First Name:AUBREY
Middle Name:C
Last Name:GAIL
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:PO BOX 264
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-0264
Mailing Address - Country:US
Mailing Address - Phone:207-725-0770
Mailing Address - Fax:207-373-0908
Practice Address - Street 1:49 TOPSHAM FAIR MALL RD
Practice Address - Street 2:SUITE 22
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1734
Practice Address - Country:US
Practice Address - Phone:207-725-0770
Practice Address - Fax:207-373-0908
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM7405OtherPTAN
MEMM7405OtherPTAN
0023541Medicare PIN