Individual
GARY MICHAEL TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
2217 E FRANKLIN ST, RICHMOND, VA 23223-7046
(804) 213-0249
(804) 716-0715
Mailing address
2217 E FRANKLIN ST, RICHMOND, VA 23223-7046
(804) 213-0249
(804) 716-0715
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710102978
VA
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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