Provider Demographics
NPI:1386399855
Name:GAGE HOLDINGS INCORPORATED
Entity type:Organization
Organization Name:GAGE HOLDINGS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-677-8387
Mailing Address - Street 1:128 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5229
Mailing Address - Country:US
Mailing Address - Phone:304-677-8387
Mailing Address - Fax:
Practice Address - Street 1:328 MILL CREEK WAY
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-0112
Practice Address - Country:US
Practice Address - Phone:304-677-8387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service