Provider Demographics
NPI:1740561547
Name:GUNN, RAHSHANDO
Entity Type:Individual
Prefix:MS
First Name:RAHSHANDO
Middle Name:
Last Name:GUNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WESTLAND ST
Mailing Address - Street 2:#39
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1762
Mailing Address - Country:US
Mailing Address - Phone:508-521-9180
Mailing Address - Fax:
Practice Address - Street 1:22 WESTLAND ST
Practice Address - Street 2:#39
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1762
Practice Address - Country:US
Practice Address - Phone:508-521-9180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist