| Doctor Name: | MRS. GLORIA CRENSHAW GASKIN |
| NPI Number: | 1891109732 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPT |
| License Number: | PT003068 |
| Business Practice Address: | 113 Myrtlewood Dr Guyton, GA - 313126811 |
| Business Phone Number: | 9127283370 |
| Business Fax Number: | |
| Mailing Address: | 113 Myrtlewood Dr, GUYTON |
| State: | GA |
| Postal Code: | 313126811 |
| Phone Number: | 9127283370 |
| Fax Number: | |
| NPI Enumeration Date: | 06/18/2014 |
| NPI Last Update Date: | 06/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | PT003068 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |