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Individual

NAKEDRA EUNIQUE GAVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT,DPT

Contact information

Practice address
22 CROSBY DR, LAUREL, MS 39440-5413
(601) 433-1228
Mailing address
22 CROSBY DR, LAUREL, MS 39440-5413

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24285
MD

Other

Enumeration date
01/08/2014
Last updated
01/08/2014
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