Provider Demographics
NPI:1780632786
Name:GAY, NATHANAEL KENT (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:NATHANAEL
Middle Name:KENT
Last Name:GAY
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Gender:M
Credentials:MS, PT
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Mailing Address - Street 1:3307 COLLINGWOOD ST NE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-3610
Mailing Address - Country:US
Mailing Address - Phone:540-362-5494
Mailing Address - Fax:
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:PHYSICAL MEDICINE AND REHABILITATION SERVICE, 117C
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6404
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:540-983-1038
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA2305202311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist