Individual
MR. GUSTAVE JEAN-LOUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
965 HAVENSTONE WALK, LAWRENCEVILLE, GA 30045-9706
(770) 736-6383
Mailing address
965 HAVENSTONE WALK, LAWRENCEVILLE, GA 30045-9706
(770) 736-6383
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002345
GA
Other
Enumeration date
02/26/2009
Last updated
02/26/2009
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