Individual
GINA CANDREVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 LAKEVIEW DR, PINEVILLE, NC 28134-7567
(704) 889-0169
Mailing address
9629 ASHLEY LAKE CT APT F, CHARLOTTE, NC 28262-1715
(828) 640-2213
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5702
NC
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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