| Doctor Name: | JASON CARL GATLIN |
| NPI Number: | 1245256015 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.P.T. |
| License Number: | 10409-024 |
| Business Practice Address: | 200 East Tyrannena Road Therapy And Sport Center Lake Mills, WI - 53551 |
| Business Phone Number: | 9206488170 |
| Business Fax Number: | |
| Mailing Address: | 230 Tamarack Dr Apt 6, LAKE MILLS |
| State: | WI |
| Postal Code: | 535511983 |
| Phone Number: | 9202790320 |
| Fax Number: | |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 10409-024 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |