Individual
RYAN GALLANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
145 CONY RD, AUGUSTA, ME 04330-0501
(207) 441-0019
Mailing address
10 MOOSE CIR, AUGUSTA, ME 04330-7886
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1198
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279210099
—
ME
Enumeration date
05/27/2009
Last updated
09/11/2009
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