Individual
JOHN GILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2200 WALLACE BLVD, SUITE E, CINNAMINSON, NJ 08077-2578
(856) 829-0015
(856) 829-0043
Mailing address
4175 VETERANS MEMORIAL HWY, STE 202, RONKONKOMA, NY 11779-7639
(631) 580-5200
(631) 580-5222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01495300
NJ
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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