Individual
MRS. JESSICA E GALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1760 N WOODLAND AVE, FAYETTEVILLE, AR 72703-2549
(479) 443-4420
(479) 443-0547
Mailing address
3917 S OLD MISSOURI RD, SPRINGDALE, AR 72764-7321
(479) 872-1800
(479) 872-4654
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2328
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181199721
—
AR
Enumeration date
04/26/2010
Last updated
04/26/2010
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