Individual
MS. MEGAN ANN GULLICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
775 POLE LINE RD W STE 202, TWIN FALLS, ID 83301-5820
(208) 814-2574
Mailing address
3989 N 3610 E, KIMBERLY, ID 83341-5505
(208) 599-4406
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3251
ID
Other
Enumeration date
08/15/2013
Last updated
02/15/2018
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