Individual
JACQUELINE CULTRA GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
904 TEMPLETON RD, MARTIN, TN 38237-5633
(731) 588-0814
(731) 587-5012
Mailing address
904 TEMPLETON RD, MARTIN, TN 38237-5633
(731) 588-0814
(731) 587-5012
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2484
TN
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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