Individual
GWYN GUMALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4541 PANTINA WAY, INDIANAPOLIS, IN 46237-5076
(937) 554-9036
Mailing address
4541 PANTINA WAY, INDIANAPOLIS, IN 46237-5076
(937) 554-9036
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007985A
IN
Other
Enumeration date
09/08/2008
Last updated
09/08/2008
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