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General NPI Number Information
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NPI Number | 1568608396
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Entity Type | Organization
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Legal Business Name | GALLAGHER CHIROPRACTIC PC
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 520 S MERIDIAN RD STE 50
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City | MERIDIAN
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State | ID
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Zip | 83642-4533
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Country | US
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Telephone | 208-989-4110
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Fax |
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Provider Business Mailing Address
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Address Line | 520 S MERIDIAN RD STE 50
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City | MERIDIAN
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State | ID
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Zip | 83642-4533
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Country | US
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Telephone | 208-989-4110
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD D GALLAGHER
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Credential | D.C.
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Telephone | 208-989-4110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | CHIA-1113
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License Number State | ID
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