GONZALO JAVIER REVUELTA

CHARLESTON, SC
NPI1457520520
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084N0400X Psychiatry & Neurology, Neurology
(Licence: SC  1400)
Additional Taxonomies2084N0400X Psychiatry & Neurology, Neurology
(Licence: PA  OT010760)
2084N0400X Psychiatry & Neurology, Neurology
(Licence: GA  060598)
Enumeration Date2008-02-22
Last Update Date2010-06-10
Business Address
Dr. GONZALO JAVIER REVUELTA D.O.
171 ASHLEY AVE
CHARLESTON, SC 29425-0100
Phone number: 843-792-1414
Mailing Address
Dr. GONZALO JAVIER REVUELTA D.O.
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200