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General NPI Number Information
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NPI Number | 1649930504
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Entity Type | Organization
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Legal Business Name | AMIE GAHAN PHYSICAL THERAPY AND WELLNESS INC
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Dates
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Enumeration Date | 12/20/2021
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 542 LIGHTHOUSE AVE UNIT 106
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-2777
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Country | US
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Telephone | 310-938-2038
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Fax |
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Provider Business Mailing Address
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Address Line | 680 LIGHTHOUSE AVE UNIT 51695
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-8083
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER/PT
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Name | DR. AMIE ROVANE GAHAN
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Credential | DPT
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Telephone | 310-938-2038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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