Individual
MARIE GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8382 EASTON RD, OTTSVILLE, PA 18942-9688
(610) 847-5708
Mailing address
8382 EASTON RD, OTTSVILLE, PA 18942-9688
(610) 847-5708
Taxonomy
Speciality
Code
Description
License number
State
163WM1400X
Nurse Massage Therapist (NMT)
Primary
RN563205
PA
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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