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General NPI Number Information
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NPI Number | 1730320383
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Entity Type | Organization
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Legal Business Name | COLLEEN P. GALLAGHER, DC, A PROFESSIONAL CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 11/18/2009
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Provider Practice Location Address
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Address Line | 17145 VON KARMAN AVE STE 103
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City | IRVINE
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State | CA
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Zip | 92614-0907
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Country | US
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Telephone | 949-225-6111
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Fax | 949-225-6114
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Provider Business Mailing Address
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Address Line | 17145 VON KARMAN AVE STE 103
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City | IRVINE
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State | CA
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Zip | 92614-0907
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Country | US
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Telephone | 949-225-6111
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Fax | 949-225-6114
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Authorized Official
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Title or Position | CHIROPRACTOR, OWNER
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Name | DR. COLLEEN P GALLAGHER
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Credential | D.C.
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Telephone | 949-225-6111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC-29969
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | DC-29969
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License Number State | CA
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