Healthcare Provider Details

I. General information

NPI: 1447377353
Provider Name (Legal Business Name): GAYLE HOVE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 JANES RD
ARCATA CA
95521-4742
US

IV. Provider business mailing address

PO BOX 504
BAYSIDE CA
95524-0504
US

V. Phone/Fax

Practice location:
  • Phone: 707-825-4950
  • Fax: 707-825-4951
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14347
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: