Individual provider · Type 1 NPI
Iris Levon Gathers, CERTIFIED HAIR LOSS
Prosthetics Case Management · Port St. Joe, FL
NPI number
1235628637
Active
Practice location
200 Reid Ave
Port St. Joe, FL 32456-1824
Mailing address
PO Box 1142
Port St. Joe, FL 32457-1142
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Prosthetics Case Management Primary | 1744P3200X | L1709270000753 (FL) |
Prosthetics Case Management: A case manager who provides services for patients with prosthetics.
About NPI 1235628637
Iris Levon Gathers, CERTIFIED HAIR LOSS's National Provider Identifier is 1235628637, issued on May 2, 2018. The primary taxonomy on file is Prosthetics Case Management (1744P3200X), and the practice location is in Port St. Joe, FL. The record was last updated on May 2, 2018.