| Doctor Name: | KATHLEEN MANTZ GOTWALS |
| NPI Number: | 1033119482 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MA002439L |
| Business Practice Address: | 2781 Geryville Pike Pennsburg, PA - 180732306 |
| Business Phone Number: | 2156798071 |
| Business Fax Number: | 2155414171 |
| Mailing Address: | Po Box 216, PENNSBURG |
| State: | PA |
| Postal Code: | 180730216 |
| Phone Number: | 2156798071 |
| Fax Number: | 2155414171 |
| NPI Enumeration Date: | 07/28/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA002439L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |