Provider Demographics
NPI:1588723498
Name:GASKEY, RAY B (DC)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:B
Last Name:GASKEY
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 1:3000 JOHNSON FERRY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5697
Mailing Address - Country:US
Mailing Address - Phone:770-552-7979
Mailing Address - Fax:770-552-1153
Practice Address - Street 1:3000 JOHNSON FERRY RD STE 102
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5697
Practice Address - Country:US
Practice Address - Phone:770-552-7979
Practice Address - Fax:770-552-1153
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006197111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician