Individual
NATHANAEL E GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2499 W COTA DR, BLOOMINGTON, IN 47403-4217
(812) 353-9378
(812) 353-5434
Mailing address
2499 W COTA DR, BLOOMINGTON, IN 47403-4217
(812) 353-9378
(812) 353-5434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011183A
IN
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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