| Doctor Name: | THOMAS GILLIS |
| NPI Number: | 1255700670 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ATP |
| License Number: | ATP14464 |
| Business Practice Address: | 7 Irwin Ln Berwick, ME - 039012874 |
| Business Phone Number: | 2074598718 |
| Business Fax Number: | |
| Mailing Address: | 7 Irwin Ln, BERWICK |
| State: | ME |
| Postal Code: | 039012874 |
| Phone Number: | 2074598718 |
| Fax Number: | |
| NPI Enumeration Date: | 09/15/2015 |
| NPI Last Update Date: | 09/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225CA2400X |
| License Number: | ATP14464 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Rehabilitation Counselor |
| Taxonomy Specialization: | Assistive Technology Practitioner |
| Taxonomy Definition: | |