Individual
NICHOLAS ALAN GUNTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3825 HIGHWAY 80 E, PEARL, MS 39208-4232
(601) 939-3030
(601) 939-3042
Mailing address
3825 HIGHWAY 80 E, PEARL, MS 39208-4232
(601) 939-3030
(601) 939-3042
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5727
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00538755
—
MS
01
—
453893ZRYN
MEDICARE PTAN
MS
Enumeration date
10/30/2015
Last updated
04/04/2016
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