Individual
GINA PUGACZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7405 DAILEY LN, CAMP LEJEUNE, NC 28547-4507
(443) 845-0137
Mailing address
7405 DAILEY LN, CAMP LEJEUNE, NC 28547-4507
(443) 845-0137
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P19664
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014625289-01
TRICARE
—
01
—
30629242
LICENSE
—
Enumeration date
10/12/2021
Last updated
10/12/2021
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