Healthcare Provider Details

I. General information

NPI: 1467392225
Provider Name (Legal Business Name): KATLYN GALL ATC, PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30335 OREGON RD
PERRYSBURG OH
43551-4539
US

IV. Provider business mailing address

1359 JUNIOR DR
MAUMEE OH
43537-3066
US

V. Phone/Fax

Practice location:
  • Phone: 419-509-5744
  • Fax:
Mailing address:
  • Phone: 419-509-5744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA.10295
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.003826
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: