Individual
SUNRISE GERVAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1874 SLAUGHTER RD, SUITE M, MADISON, AL 35758-5906
(256) 431-7672
Mailing address
212 S CLINTON ST, ATHENS, AL 35611-2616
(256) 431-7672
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT 2560
AL
Other
Enumeration date
12/22/2014
Last updated
12/22/2014
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