Individual
GARRY GILLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
540 KINGSLEY AVE, ORANGE PARK, FL 32073-4847
(904) 536-0548
(904) 264-8350
Mailing address
802 S LILAC LOOP, JACKSONVILLE, FL 32259-1919
(904) 536-0548
(904) 264-8350
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL52
FL
Other
Enumeration date
02/13/2006
Last updated
07/08/2007
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