Individual
DAVID LEOR GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3935 BRIAN JORDAN PL, STE 119, HIGH POINT, NC 27265-8036
(336) 885-0440
(336) 885-0442
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 362-8684
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P15717
NC
225100000X
Physical Therapist
PT011099
GA
Other
Enumeration date
08/01/2013
Last updated
02/28/2017
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