Healthcare Provider Details

I. General information

NPI: 1477535441
Provider Name (Legal Business Name): MRS. CATHERINE J GALLAGHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14535 JOHN MARSHALL HIGHWAY SUITE 203
GAINESVILLE VA
20155
US

IV. Provider business mailing address

14535 JOHN MARSHALL HIGHWAY SUITE 203
GAINESVILLE VA
20155
US

V. Phone/Fax

Practice location:
  • Phone: 703-753-0974
  • Fax: 703-753-9709
Mailing address:
  • Phone: 703-753-0974
  • Fax: 703-753-9709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305004656
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: