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Individual

JEANNE GALLIEN GORMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR L

Contact information

Practice address
2208 N YELLOWOOD AVE, BROKEN ARROW, OK 74012-9102
(918) 286-1261
Mailing address
2208 N YELLOWOOD AVE, BROKEN ARROW, OK 74012-9102
(918) 286-1261

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1581
OK

Other

Enumeration date
07/01/2008
Last updated
09/13/2010
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