Individual
GAVIN MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T
Contact information
Practice address
2600 BELLE CHASSE HWY, SUITE 208, TERRYTOWN, LA 70056-7156
(504) 433-8744
(504) 433-8740
Mailing address
4633 WICHERS DR, MARRERO, LA 70072-3064
(504) 347-5421
(504) 378-9331
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03245PT
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT03245
PT LICENSE NUMBER
LA
Enumeration date
07/06/2006
Last updated
07/08/2007
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