MEDICARE: SARAH W GALLAGHER R.D.

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	133V00000X	Registered Dietitian	725030	MT

General Provider Information

NPI Number	:	1437345584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH W GALLAGHER R.D.

Provider Business Mailing Address
First Line	:	3447 HANNIBAL ST
Second Line	:
City	:	BUTTE
State	:	MT
Zip	:	59701-4523
Country	:	US
Telephone Number	:	406-494-0199
Fax Number	:

Provider Business Practice Location Address
First Line	:	3447 HANNIBAL ST
Second Line	:
City	:	BUTTE
State	:	MT
Zip	:	59701-4523
Country	:	US
Telephone Number	:	406-494-0199
Fax Number	:

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

Provider Enumeration Date	:	09/22/2007
Last Update Date	:	09/22/2007

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