Individual
TEVIN M GILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5170 US RT 60 EAST, HUNTINGTON, WV 25705
(304) 528-4600
Mailing address
5170 US RT 60 EAST, HUNTINGTON, WV 25705
(304) 528-4600
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1244
WV
Other
Enumeration date
07/19/2012
Last updated
11/30/2021
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