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General NPI Number Information
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NPI Number | 1528963618
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Entity Type | Individual
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Provider Name | TERRRANTHIUM YENEY GALLOWAY
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Gender | Male
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 1475 SAND BAY DR SW APT 9003
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City | ATLANTA
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State | GA
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Zip | 30331-8981
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Country | US
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Telephone | 404-321-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 1475 SAND BAY DR SW APT 9003
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City | ATLANTA
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State | GA
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Zip | 30331-8981
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Country | US
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Telephone | 404-321-6111
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Fax |
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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 | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | 1103822
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License Number State | GA
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