Individual
MR. GARRY GABIONZA TAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
221 N MARION ST, UNIT 1A, OAK PARK, IL 60302-1936
(708) 386-0136
Mailing address
221 N MARION ST, UNIT 1A, OAK PARK, IL 60302-1936
(708) 386-0136
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070013388
IL
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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