NPI 1114661113

Jarryl Gatling

Practitioner Driver Virginia Beach, VA

Practice location

Address: 516 White Oak Dr, Virginia Beach, VA 23462-4221
Phone: (510) 798-2649

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence A60303723 (VA)

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Registry record

NPI: 1114661113
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Apr 2022
Record last updated: 25 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.