| Doctor Name: | MR. ROLLY GALLEGO ELACO |
| NPI Number: | 1649500265 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 5501011330 |
| Business Practice Address: | 38765 Mound Rd Suite 101 Sterling Heights, MI - 483103209 |
| Business Phone Number: | 5862740750 |
| Business Fax Number: | 5862740704 |
| Mailing Address: | 42460 Silverwood Dr, STERLING HEIGHTS |
| State: | MI |
| Postal Code: | 483142941 |
| Phone Number: | 3137290799 |
| Fax Number: | 5862740704 |
| NPI Enumeration Date: | 01/04/2010 |
| NPI Last Update Date: | 01/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501011330 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |