Organization
GATEWAY REHABILITATION COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY D HAWKINS LPT (OWNER)
(618) 258-9093
Entity
Organization
Contact information
Practice address
935 EAST AIRLINE DR, EAST ALTON, IL 62024
(618) 258-9093
(618) 258-9097
Mailing address
935 EAST AIRLINE DR, EAST ALTON, IL 62024
(618) 258-9093
(618) 258-9097
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/21/2006
Last updated
07/12/2010
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