Provider Demographics
NPI:1285496174
Name:DURAN DE GANTE CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:DURAN DE GANTE CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DURAN DE GANTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:707-385-4713
Mailing Address - Street 1:807 HEALDSBURG AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3654
Mailing Address - Country:US
Mailing Address - Phone:707-385-4713
Mailing Address - Fax:
Practice Address - Street 1:807 HEALDSBURG AVE STE 100
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3654
Practice Address - Country:US
Practice Address - Phone:707-385-4713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty