Individual
MRS. PEGGY ANNE GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-4104
Mailing address
203 BILL NAVE LOOP, ELIZABETHTON, TN 37643-5575
(423) 844-4104
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000006845
TN
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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