Individual
ETHAN DANIEL GALLAGHER
Active
Individual
ETHAN DANIEL GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT032515
PA
2251P0200X
Pediatric Physical Therapist
TPT023830
PA
Other
Enumeration date
05/23/2024
Last updated
01/29/2025
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