MEDICARE: JAN VINCENT GALANG

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

General Provider Information

NPI Number	:	1548832215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAN VINCENT GALANG

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-682-8840
Fax Number	:

Provider Business Practice Location Address
First Line	:	5950 WILLOW LN
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-5315
Country	:	US
Telephone Number	:	971-501-7466
Fax Number	:

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

Provider Enumeration Date	:	07/13/2021
Last Update Date	:	07/13/2021

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Directions to “ JAN VINCENT GALANG ” Practice Location

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