Individual
KENDRICK D GATEWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2121 FOUNTAIN DR STE F, SNELLVILLE, GA 30078-2900
(678) 353-6568
(678) 821-2745
Mailing address
1787 BRISTOL FARMS CT, GRAYSON, GA 30017-2927
(770) 617-7242
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008846
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639824568
BUSINESS NPI NUMBER
GA
Enumeration date
08/14/2013
Last updated
05/17/2023
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