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Individual

BARBARA ANN GABUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
8840 CYPRESS WATERS BLVD, COPPELL, TX 75019-4594
(800) 788-4815
Mailing address
3324 DUNE DR, LAKE HAVASU CITY, AZ 86404-1512
(509) 628-7209

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
PTA A-0446
NV
174400000X
Specialist
PTA 00738
IA
174400000X
Specialist
PTA 2070020
TX
174400000X
Specialist
Primary
PTA 7963A
AZ
174400000X
Specialist
PTA 8459
OR

Other

Enumeration date
05/31/2007
Last updated
10/07/2016
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