Provider Demographics
NPI:1255456901
Name:GABRIELSON, PAUL ERIC (MA, ATC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ERIC
Last Name:GABRIELSON
Suffix:
Gender:M
Credentials:MA, ATC
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Mailing Address - Street 1:291 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-6700
Mailing Address - Country:US
Mailing Address - Phone:805-441-5314
Mailing Address - Fax:
Practice Address - Street 1:1 GRAND AVE
Practice Address - Street 2:ATHLETICS
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93407-9000
Practice Address - Country:US
Practice Address - Phone:805-756-2096
Practice Address - Fax:805-756-7058
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2015-02-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer