Individual
MICHELLE GILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5715 LAMOS RD, WHITEHALL, MI 49461-9616
(231) 981-5149
Mailing address
5715 LAMOS RD, WHITEHALL, MI 49461-9616
(231) 981-5149
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502002740
MI
225700000X
Massage Therapist
7501002314
MI
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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