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Individual

MR. THOMAS PATRICK GALLAGHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
2708 RUTH WAY, PHILADELPHIA, PA 19114
(215) 649-0022
Mailing address
2708 RUTH WAY, PHILADELPHIA, PA 19114-3499
(215) 649-0022

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000036367
390200000X
Student in an Organized Health Care Education/Training Program
PA

Other

Enumeration date
08/29/2018
Last updated
06/12/2019
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