Individual
MRS. CHARLOTTE ELIZABETH WEISS GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
21 HERITAGE DR STE 101, BOURBONNAIS, IL 60914-1465
(815) 937-8220
(815) 937-8222
Mailing address
21 HERITAGE DR STE 101, BOURBONNAIS, IL 60914-1465
(815) 937-8220
(815) 937-8222
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004550
IL
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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