MEDICARE: MICHELLE GAVURA PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	6249	AZ

General Provider Information

NPI Number	:	1952736159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE GAVURA PT

Provider Business Mailing Address
First Line	:	PO BOX 5924
Second Line	:	7208 E. CAVE CREEK RD
City	:	CAREFREE
State	:	AZ
Zip	:	85377-5924
Country	:	US
Telephone Number	:	480-488-9095
Fax Number	:	480-488-2862

Provider Business Practice Location Address
First Line	:	7208 E. CAVE CREEK RD
Second Line	:
City	:	CAREFREE
State	:	AZ
Zip	:	85337-5924
Country	:	US
Telephone Number	:	480-488-9095
Fax Number	:	480-488-2862

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2013
Last Update Date	:	09/06/2013

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Directions to “ MICHELLE GAVURA PT” Practice Location

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