Individual
ANTHONY JOHN GAGE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
320 W RIDGE RD, WYTHEVILLE, VA 24382-1009
(276) 228-8775
Mailing address
320 W RIDGE RD, WYTHEVILLE, VA 24382-1009
(276) 228-8775
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006193
VA
Other
Enumeration date
11/28/2007
Last updated
11/28/2007
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