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General NPI Number Information
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NPI Number | 1215095690
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Entity Type | Individual
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Provider Name | JOHN W GALBREATH DC
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1417 WASHINGTON AVE
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City | ALTON
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State | IL
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Zip | 62002-3964
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Country | US
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Telephone | 618-465-2419
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Fax | 618-463-0759
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Provider Business Mailing Address
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Address Line | 4803 TERRACE LN
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City | GODFREY
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State | IL
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Zip | 62035-1116
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Country | US
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Telephone | 618-465-2419
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Fax | 618-463-0759
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 |
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License Number State | IL
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