MEDICARE: GALLOWAY THERAPY PLLC

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	PT2501	AR

General Provider Information

NPI Number	:	1306161104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALLOWAY THERAPY PLLC

Provider Business Mailing Address
First Line	:	4624 E 43RD ST
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2648
Country	:	US
Telephone Number	:	501-319-7659
Fax Number	:	501-353-2781

Provider Business Practice Location Address
First Line	:	4624 E 43RD ST
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2648
Country	:	US
Telephone Number	:	501-319-7659
Fax Number	:	501-353-2781

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN C GALLOWAY
Credential	:	PT
Telephone Number	:	501-319-7659

Provider Enumeration Date	:	04/05/2010
Last Update Date	:	10/03/2019

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