Doctor Name: | WILLIAM GAMBRELL |
NPI Number: | 1942582747 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | MA59397 |
Business Practice Address: | 24850 Old Hwy 41 Rd Suite 17 Bonita Springs, FL - 34135 |
Business Phone Number: | 2399473900 |
Business Fax Number: | 2392360647 |
Mailing Address: | 3304 19th St W, LEHIGH ACRES |
State: | FL |
Postal Code: | 339715531 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/16/2011 |
NPI Last Update Date: | 09/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA59397 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |