Individual
PATRICIA ANN GASAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
524 W CENTRE AVE, PORTAGE, MI 49024-5306
(269) 324-1180
Mailing address
8006 E W AVE, VICKSBURG, MI 49097-9202
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703043025
MI
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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