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Individual

MRS. ADA LADELLE GALLANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL, LPTA

Contact information

Practice address
6535 DRAKE RD, WEST BLOOMFIELD, MI 48322
(810) 240-3453
Mailing address
7057 GRANGER DR, HOWELL, MI 48855-7266

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
5502001938
MI
225X00000X
Occupational Therapist
Primary
5201009263
MI

Other

Enumeration date
04/18/2013
Last updated
08/23/2018
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