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NPI Code Detail

MEDICARE: GENA GALLOWAY

MEDICARE:   GENA  GALLOWAY
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
1164W00000XLicensed Practical NursePN.132668-M-IVOH

General Provider Information

NPI Number : 1700138450
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENA GALLOWAY
Provider Business Mailing Address
First Line : 10877 MIDDLEBURG PLAIN CITY RD
Second Line :
City : NORTH LEWISBURG
State : OH
Zip : 43060-9709
Country : US
Telephone Number : 937-243-9374
Fax Number :
Provider Business Practice Location Address
First Line : 10877 MIDDLEBURG PLAIN CITY RD
Second Line :
City : NORTH LEWISBURG
State : OH
Zip : 43060-9709
Country : US
Telephone Number : 937-243-9374
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2012
Last Update Date : 10/04/2012

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Directions to “ GENA GALLOWAY ” Practice Location

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