Individual
GERALD POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
475 29TH ST, OAKLAND, CA 94609-3510
(510) 832-3222
Mailing address
590 EL DORADO AVE UNIT 205, OAKLAND, CA 94611-5072
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10976
CA
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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