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Individual

TASHA GALLUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
101 BOULDER POINT DR STE 1, PLYMOUTH, NH 03264-3170
(603) 536-4000
(603) 536-4001
Mailing address
101 BOULDER POINT DR STE 1, PLYMOUTH, NH 03264-3170
(603) 536-4000
(603) 536-4001

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0353
NH
363AM0700X
Medical Physician Assistant
Primary
1256
NH

Other

Enumeration date
08/29/2014
Last updated
02/07/2025
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