Individual
KIRK GOTWALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2189 EASTMAN AVE, VENTURA, CA 93003-5792
(805) 639-2600
Mailing address
2323 KNOLL DR, VENTURA, CA 93003-7307
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT5507
CA
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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