Individual
MS. MARTHA J GALLAGHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
1201 ATKINS RD, RUSTON, LA 71270-8717
(318) 255-9105
Mailing address
PO BOX 1331, RUSTON, LA 71273-1331
(318) 255-9105
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTT.Z10170
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1300454
—
LA
Enumeration date
01/16/2008
Last updated
01/16/2008
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