Individual
GALLAGHER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1304 NW CIVIC DR, GRESHAM, OR 97030-5569
(503) 512-1040
Mailing address
1304 NW CIVIC DR, GRESHAM, OR 97030-5569
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19340
OR
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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