Organization
GATSON SERVICE PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OPHELIA E GATSON (PASTOR)
(804) 398-1204
Entity
Organization
Contact information
Practice address
2902 NOBLE AVE, RICHMOND, VA 23222-3541
(804) 398-1204
Mailing address
2902 NOBLE AVE, RICHMOND, VA 23222-3541
(804) 398-1204
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
07/16/2014
Last updated
07/16/2014
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