Healthcare Provider Details

I. General information

NPI: 1285768945
Provider Name (Legal Business Name): GAIL HEATHER GALLAGHER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16605 E PALISADES BLVD SUITE 144
FOUNTAIN HILLS AZ
85268-3716
US

IV. Provider business mailing address

9097 E DESERT COVE DR SUITE 110
SCOTTSDALE AZ
85260-6279
US

V. Phone/Fax

Practice location:
  • Phone: 480-837-2595
  • Fax: 480-837-2773
Mailing address:
  • Phone: 480-837-2595
  • Fax: 480-837-0356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1158570
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6549
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: