Individual
TOM GOLLICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT AIDE
Contact information
Practice address
151 BLAIR PARK RD, WILLISTON, VT 05495-7435
(802) 879-0909
Mailing address
151 BLAIR PARK RD, PO BOX 1064, WILLISTON, VT 05495-7435
(802) 879-0909
(802) 879-3095
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
041-0000469
VT
Other
Enumeration date
12/04/2006
Last updated
11/14/2007
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