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General NPI Number Information
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NPI Number | 1003038266
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Entity Type | Organization
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Legal Business Name | CHARLES GALLAGHER PT, PS
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 11402 N NEWPORT HWY SUITE B
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City | SPOKANE
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State | WA
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Zip | 99218-1616
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Country | US
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Telephone | 509-464-1813
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Fax | 509-464-4813
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Provider Business Mailing Address
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Address Line | 11402 N NEWPORT HWY SUITE B
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City | SPOKANE
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State | WA
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Zip | 99218-1616
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Country | US
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Telephone | 509-464-1813
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Fax | 509-464-4813
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. JULIE ANN GALLAGHER
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Credential |
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Telephone | 209-464-1813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT00007501
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License Number State | WA
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