Individual
EDWARD FRANCIS GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
165 AVONDALE DR, MYRTLE BEACH, SC 29588-5404
(843) 650-5684
Mailing address
165 AVONDALE DR, MYRTLE BEACH, SC 29588-5404
(843) 650-5684
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3353
SC
Other
Enumeration date
10/30/2015
Last updated
10/30/2015
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