Provider Demographics
NPI:1558065326
Name:VON ARX, GABRIELLA TAYLOR
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:TAYLOR
Last Name:VON ARX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 KINGSWOOD RD NW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-2075
Mailing Address - Country:US
Mailing Address - Phone:252-289-4604
Mailing Address - Fax:
Practice Address - Street 1:1107 KINGSWOOD RD NW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-2075
Practice Address - Country:US
Practice Address - Phone:252-289-4604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer