Individual
TAMMY RACHELLE GILLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT, ATC
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1079
Mailing address
1713 HENDOLA DR NE, ALBUQUERQUE, NM 87110-5521
(505) 323-3855
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2951
NM
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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