| Doctor Name: | KERI LYN GUSTAVSEN |
| NPI Number: | 1063444743 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 1161526 |
| Business Practice Address: | 100 Country Club Rd Ste 120 Argyle, TX - 762262358 |
| Business Phone Number: | 9404640055 |
| Business Fax Number: | 9404647755 |
| Mailing Address: | Po Box 372, ARGYLE |
| State: | TX |
| Postal Code: | 762260372 |
| Phone Number: | 9404640055 |
| Fax Number: | 9404647755 |
| NPI Enumeration Date: | 07/06/2006 |
| NPI Last Update Date: | 11/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 1161526 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |