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General NPI Number Information
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NPI Number | 1962520163
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Entity Type | Individual
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Provider Name | SHEILA MARIE GALLOP PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 10/16/2014
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Provider Practice Location Address
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Address Line | 10 KAY LN APT D
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City | WATERBURY
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State | CT
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Zip | 06708-1342
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Country | US
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Telephone | 203-575-0027
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Fax |
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Provider Business Mailing Address
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Address Line | 165 BRADLEY RD
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City | MILFORD
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State | ME
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Zip | 04461-3610
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Country | US
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Telephone | 207-827-1221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2607
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License Number State | ME
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