Individual
SUSAN GILLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
(671) 224-2040
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
(671) 224-2040
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1341
NE
Other
Enumeration date
03/04/2015
Last updated
03/04/2015
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