Individual
DIANDRA GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
53 PARK AVE, WINTHROP, MA 02152-2559
(617) 230-2275
Mailing address
53 PARK AVE, WINTHROP, MA 02152-2559
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3412
MA
Other
Enumeration date
07/28/2017
Last updated
10/09/2021
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