Organization
GATEAU PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONNIE B GATEAU PT (CEO OWNER)
(410) 326-3432
Entity
Organization
Contact information
Practice address
11855 HG TRUEMAN RD, LUSBY, MD 20657-2855
(410) 326-3432
(410) 326-2493
Mailing address
11855 HG TRUEMAN RD, LUSBY, MD 20657-2855
(410) 326-3432
(410) 326-2493
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157770
AETNA HMO
—
01
—
411592
OPTIMUM CHOICE MAMSI MDIP
—
01
—
5257158
PPO
—
01
—
KAA9
BCBS OF MD
—
01
—
S8880001
CAREFIRST DC
—
Enumeration date
01/03/2006
Last updated
04/20/2008
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