Individual
MRS. JEANETTE GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3244 BAILEY ST NW, MASSILLON, OH 44646-3616
(330) 833-3110
(330) 833-3115
Mailing address
3244 BAILEY ST NW, MASSILLON, OH 44646-3616
(330) 833-3110
(330) 833-3115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003032
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM0529
MEDICARE ID TYPE UNSPEC
OH
Enumeration date
03/31/2006
Last updated
01/05/2009
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