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Individual

SHELLEY KAY GAUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1101 W 9TH ST, DAVENPORT, IA 52804-3732
(563) 324-1621
Mailing address
5403 VICTORIA AVE, DAVENPORT, IA 52807-3925
(563) 327-0132

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001210
IA
225200000X
Physical Therapy Assistant
IL

Other

Enumeration date
10/25/2007
Last updated
10/25/2007
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