Individual
DR. JACK GILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
288 S PACIFIC HWY, TALENT, OR 97540-6649
(541) 482-6360
Mailing address
36 HAWTHORNE ST, MEDFORD, OR 97504-7114
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
65317
OR
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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