Individual
TERRY L. GAULT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.A., ATC, LAT
Contact information
Practice address
1 GREYHOUND LN, BOERNE, TX 78006-1810
(830) 357-2287
Mailing address
26403 BUBBLING BRK, SAN ANTONIO, TX 78258-5346
(830) 980-8932
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1448
TX
Other
Enumeration date
02/20/2006
Last updated
07/08/2007
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