MEDICARE: DEBORAH GALLANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5553	MA

General Provider Information

NPI Number	:	1144623539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH GALLANT

Provider Business Mailing Address
First Line	:	20 N PARK AVE
Second Line	:	SUITE 1300
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-4090
Country	:	US
Telephone Number	:	508-830-0999
Fax Number	:	508-830-0943

Provider Business Practice Location Address
First Line	:	20 N PARK AVE
Second Line	:	SUITE 1300
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-4090
Country	:	US
Telephone Number	:	508-830-0999
Fax Number	:	508-830-0943

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2014
Last Update Date	:	09/30/2014

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Directions to “ DEBORAH GALLANT ” Practice Location

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