Provider Demographics
NPI:1154423424
Name:GAVIOLA, SANDRA L (RRT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:GAVIOLA
Suffix:
Gender:F
Credentials:RRT
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Mailing Address - Street 1:27 ANVIL MILL QUARTERS
Mailing Address - Street 2:S. LANCASTER STREET
Mailing Address - City:ANNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17003-1854
Mailing Address - Country:US
Mailing Address - Phone:412-527-9321
Mailing Address - Fax:717-228-5950
Practice Address - Street 1:VA MEDICAL CENTER
Practice Address - Street 2:1700 S. LINCOLN AVENUE
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042
Practice Address - Country:US
Practice Address - Phone:717-272-6621
Practice Address - Fax:717-228-5950
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAYO000566L227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered