Individual
SUSAN DENICE GAUTREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 E COUNTY LINE RD STE A, RIDGELAND, MS 39157-1928
(601) 487-6088
(601) 487-6068
Mailing address
950 E COUNTY LINE RD STE A, RIDGELAND, MS 39157-1928
(601) 487-6088
(601) 487-6068
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2430
MS
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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