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Individual

PRESCIOUS GATEWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5317 85TH AVE APT 202, NEW CARROLLTN, MD 20784-3216
(615) 919-4104
Mailing address
5317 85TH AVE APT 202, NEW CARROLLTN, MD 20784-3216
(615) 919-4104

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
02/07/2021
Last updated
02/07/2021
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