Individual
GABRIEL K BAINESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
734 N VILLAGE AVE APT D, BROKEN ARROW, OK 74012-2964
(509) 251-1160
Mailing address
734 N VILLAGE AVE APT D, BROKEN ARROW, OK 74012-2964
(509) 251-1160
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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