Individual
GREGORY LANDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
451 S EL CAMINO XING, SAN AUGUSTINE, TX 75972-1666
(936) 275-2900
Mailing address
3404 ROCK RIDGE ST, NACOGDOCHES, TX 75965-3238
(740) 586-5539
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
208166
UT
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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