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Individual

MRS. CHRISTINA MARIE GAUTHIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3328 WEST GENESSEE STREET, SYRACUSE, NY 13219
(315) 484-9447
(315) 484-4583
Mailing address
315 BRIDGE ST, SOLVAY, NY 13209
(315) 484-9447

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0110751
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
435103
MVP
NY
Enumeration date
09/28/2006
Last updated
07/08/2007
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