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Individual

MR. GERALD NASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
51681 HUNTINGTON RD, LA PINE, OR 97739-9626
(541) 536-6122
(541) 536-6123
Mailing address
PO BOX 1888, LA PINE, OR 97739-1888
(541) 536-6122
(541) 536-6123

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60393
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60393
OREGON PHYSICAL THERAPY LICENSE
OR
Enumeration date
10/17/2006
Last updated
10/10/2013
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