Provider Demographics
NPI:1063540383
Name:GABRIEL, KENNETH MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:MICHAEL
Last Name:GABRIEL
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 1:45 STILES RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4808
Mailing Address - Country:US
Mailing Address - Phone:603-893-1013
Mailing Address - Fax:603-893-1298
Practice Address - Street 1:45 STILES RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4808
Practice Address - Country:US
Practice Address - Phone:603-893-1013
Practice Address - Fax:603-893-1298
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH632-0401111N00000X
MA2584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHY36794OtherBCBS OF MASS.
NHRE6145Medicare ID - Type Unspecified