Individual
SALLY GUILLAUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
449 RIVER AVE, WILLIAMSPORT, PA 17701-3722
(570) 320-7458
Mailing address
449 RIVER AVE, WILLIAMSPORT, PA 17701-3722
(570) 320-7458
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI0039
PA
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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