Individual
GILAINE NETTLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1303 DR MARTIN L KING JR AVE, MOBILE, AL 36603-5341
(251) 432-4117
(251) 964-4012
Mailing address
PO BOX 1090, DAPHNE, AL 36526-1090
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23210
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51539524
BCBS PROVIDER NUMBER
AL
Enumeration date
05/17/2007
Last updated
08/10/2009
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