Individual ProviderMallory GillespiePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4383 Northlake Blvd Ste 309, Palm Beach Gardens, FL 33410-6253(561) 775-4900(561) 392-3341PECOS EnrollmentBased on the most recent information from CMS, provider Mallory Gillespie does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1184193377Provider TypeIndividualFull NameGillespie, MalloryCredentialPTGenderFemaleSole ProprietorNoEnumeration Date11/16/2018Last Updated11/16/2018Contact InformationPractice LocationPractice Address4383 Northlake Blvd Ste 309, Palm Beach Gardens, FL 33410-6253Phone(561) 775-4900FaxUnlisted FaxMailing LocationMailing Address398 Camino Gardens Blvd Ste 102, Boca Raton, FL 33432-5827Phone(561) 392-3341FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense34123Florida