Individual
BONNIE JO GALLOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3058
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3058
P.T. LICENSE
OK
Enumeration date
08/30/2006
Last updated
04/22/2009
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