Healthcare Provider Details

I. General information

NPI: 1104754332
Provider Name (Legal Business Name): CHRISTOPHER GALLION LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR
FORT CARSON CO
80913-4613
US

IV. Provider business mailing address

414 KEARNEY AVE
COLORADO SPRINGS CO
80906-4758
US

V. Phone/Fax

Practice location:
  • Phone: 804-895-1813
  • Fax:
Mailing address:
  • Phone: 804-895-1813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN.0334662
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: