Individual
JENNIFER GALLAGHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
207 CHANTICLEER LN SE, POPLAR GROVE, IL 61065-8712
(815) 765-5288
Mailing address
207 CHANTICLEER LN SE, POPLAR GROVE, IL 61065-8712
(815) 765-5288
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004742
IL
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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