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PATRICIA M GAVULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
130 FISHER RD, BERLIN, VT 05602-9516
(802) 371-4100
Mailing address
130 FISHER RD, PO BOX 547, BERLIN, VT 05602-9516
(802) 371-4100

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055-0030426
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
900210
VT
Enumeration date
07/19/2006
Last updated
07/08/2007
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