Provider Demographics
NPI:1780802041
Name:GAUTHIER, DONALD RENE (DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RENE
Last Name:GAUTHIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 PIDGEON HILL DR.
Mailing Address - Street 2:SUITE 280
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165
Mailing Address - Country:US
Mailing Address - Phone:703-404-1807
Mailing Address - Fax:
Practice Address - Street 1:2 PIDGEON HILL DR.
Practice Address - Street 2:SUITE 280
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6149
Practice Address - Country:US
Practice Address - Phone:703-404-1807
Practice Address - Fax:703-404-1827
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555777111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation