Individual
GWANA TORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 27TH AVE SW STE 9&10, VERO BEACH, FL 32968-4200
(772) 257-5264
Mailing address
2680 68TH SQ APT 202, VERO BEACH, FL 32966-8915
(772) 643-5276
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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