Individual
ROGER LEE GULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CERTIFIED REHAB THER
Contact information
Practice address
62 FAIRMOUNT AVE, CLIFTON, NJ 07011-3007
(973) 340-0890
Mailing address
62 FAIRMOUNT AVE, CLIFTON, NJ 07011-3007
(973) 340-0890
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
26BT00004800
NJ
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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