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Individual

MR. BAHAA R GERGES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
124 S FLORIDA ST, BUSHNELL, FL 33513-6704
(352) 793-8661
Mailing address
124 S FLORIDA ST, BUSHNELL, FL 33513-6704
(352) 793-8661

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT13402
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
887299600
FL
Enumeration date
05/02/2007
Last updated
10/26/2010
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