Organization
GATLING DOMESTIC AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA MOHAMMED GATLING (GENERAL MANAGER)
(336) 721-2135
Entity
Organization
Contact information
Practice address
4633 KELLYS TRL, WINSTON SALEM, NC 27101-2319
(336) 721-2135
Mailing address
4633 KELLYS TRL, WINSTON SALEM, NC 27101-2319
(336) 721-2135
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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