Individual
MS. GWEN D THESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
7710 CANNON ST, PITTSBURGH, PA 15218-2109
(412) 273-1923
Mailing address
7710 CANNON ST, PITTSBURGH, PA 15218-2109
(412) 273-1923
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
02-1841
PA
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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