Individual
MATTHEW GERVASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13447 STAFF SARGENT SIMS ST, FORT BLISS, TX 79918
(609) 828-8128
Mailing address
138 LAFAYETTE RD, AUDUBON, NJ 08106-1130
(609) 828-8128
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/08/2022
Last updated
08/10/2022
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