Individual
JILLIAN GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4911 TALL TIMBER DR APT 104, RALEIGH, NC 27612-6023
(203) 560-3380
Mailing address
4911 TALL TIMBER DR APT 104, RALEIGH, NC 27612-6023
(203) 560-3380
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
2033
CT
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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