Individual
DR. ANTONIO RAY GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
920 LAMBERT ST, NILES, MI 49120-3413
(269) 684-4200
(269) 262-0943
Mailing address
920 LAMBERT ST, NILES, MI 49120-3413
(269) 684-4200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
08001868A
IN
111N00000X
Chiropractor
2301008841
MI
111NN1001X
Nutrition Chiropractor
2301008841
MI
111NR0400X
Rehabilitation Chiropractor
Primary
2301008841
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200258400
—
IN
Enumeration date
02/27/2007
Last updated
11/06/2011
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