Most Relevant Information
Provider Data
| NPI Number: | 1003357823 |
| Provider Name: | GINA GAMBUCCI MS, LAT, ATC, OTC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/13/2017 |
| Last Updated: | 01/07/2021 |
Provider Practice Location
6308 8TH AVE
KENOSHA
WI
531435031
Practice Location Phone/Fax
| Phone: | 2626562011 |
| Fax: |
Provider Mailing Location
3229 OLD HICKORY PL
WEST BEND
WI
530958315
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |