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Individual

DR. GEORGE W GAUTHIER III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
57 DANADA SQ E, WHEATON, IL 60187-8484
(630) 682-8682
(630) 681-8366
Mailing address
57 DANADA SQ E, WHEATON, IL 60187-8484
(630) 682-8682
(630) 681-8366

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2206151
BCBS PROVIDER #
IL
Enumeration date
08/26/2005
Last updated
07/08/2007
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