Individual
ALLISON GILLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4616 N ALBINA AVE, PORTLAND, OR 97217-3012
(503) 335-9980
Mailing address
4616 N ALBINA AVE, PORTLAND, OR 97217-3012
(503) 335-9980
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09215
OR
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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