MEDICARE: MRS. SHEILA MARIE GALLAGHER-WHITLOCK PT

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	2251X0800X	Orthopedic Physical Therapist	9284	NC

General Provider Information

NPI Number	:	1447227681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEILA MARIE GALLAGHER-WHITLOCK PT

Provider Business Mailing Address
First Line	:	3605 PRITCHARD CT
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-8974
Country	:	US
Telephone Number	:	919-752-0606
Fax Number	:

Provider Business Practice Location Address
First Line	:	2115 S MAIN ST
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-5011
Country	:	US
Telephone Number	:	919-570-5755
Fax Number	:

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	07/08/2007

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