Individual
NICHOLAS JOHN GENTILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1511 HEATHER HILLS LANE, GLEN MILLS, PA 19039-0266
(610) 558-4890
Mailing address
PO BOX 266, GRADYVILLE, PA 19039-0266
(610) 558-4890
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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