Individual
GAVIN RAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
540 WEST AVE APT 1412, MIAMI BEACH, FL 33139-6782
(786) 631-0904
Mailing address
540 WEST AVE APT 1412, MIAMI BEACH, FL 33139-6782
(786) 631-0904
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/20/2015
Last updated
02/20/2015
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