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General NPI Number Information
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NPI Number | 1205920998
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Entity Type | Organization
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Legal Business Name | RICHARD D GALLAGHER DC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 12/08/2008
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Provider Practice Location Address
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Address Line | 4286 E AMITY AVE STE 104
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City | NAMPA
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State | ID
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Zip | 83687-8176
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Country | US
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Telephone | 208-442-1052
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Fax | 208-461-4685
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Provider Business Mailing Address
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Address Line | 4286 E AMITY AVE STE 104
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City | NAMPA
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State | ID
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Zip | 83687-8176
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Country | US
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Telephone | 208-442-1052
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Fax | 208-461-4685
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD D GALLAGHER
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Credential | D.C.
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Telephone | 208-442-1052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIA-1113
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License Number State | ID
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