Individual
NICK GAFFNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
104 FAKES CT, BEAVER DAM, WI 53916-2699
(920) 356-9818
Mailing address
1225 CHELSEA CT, MENASHA, WI 54952-8915
(920) 850-2561
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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