Individual
TERRENCE MICHAEL GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 SHORE DR, VIRGINIA BEACH, VA 23451-1199
(758) 496-1689
Mailing address
3904 SEEMAN RD, VIRGINIA BEACH, VA 23452-2464
(619) 204-0655
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602987
VA
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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