Individual
THERESA MARIE GILLILAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
802 COOKSON AVE SE, NEW PHILADELPHIA, OH 44663-9569
(330) 339-6692
Mailing address
802 COOKSON AVE SE, NEW PHILADELPHIA, OH 44663-9569
(330) 339-6692
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17546
OH
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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