Individual
BETH GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MSED, DHSC
Contact information
Practice address
2631 W 8TH ST, ERIE, PA 16505-4034
(814) 464-0627
Mailing address
2631 W 8TH ST, ERIE, PA 16505-4034
(814) 464-0627
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
PT001131E
PA
2251N0400X
Neurology Physical Therapist
Primary
PT001131E
PA
2251P0200X
Pediatric Physical Therapist
PT001131E
PA
2251X0800X
Orthopedic Physical Therapist
PT001131E
PA
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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