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General NPI Number Information
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NPI Number | 1659239911
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Entity Type | Individual
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Provider Name | GABRIEL JACK PAULSON DPT
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Gender | Male
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 514 SOUTH MAIN ST
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City | KENANSVILLE
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State | NC
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Zip | 28349
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Country | US
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Telephone | 910-372-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 401 N MAIN ST
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City | KENANSVILLE
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State | NC
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Zip | 28349-8801
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Country | US
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Telephone | 910-296-0941
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | P24575
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License Number State | NC
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