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General NPI Number Information
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NPI Number | 1891162343
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Entity Type | Organization
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Legal Business Name | COWBOY HEALTHCARE PLLC
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 136 E MAIN ST
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City | RAVENNA
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State | OH
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Zip | 44266-3104
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Country | US
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Telephone | 330-472-0372
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Fax | 330-649-2713
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Provider Business Mailing Address
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Address Line | 2490 MAPLEHURST DR
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City | STOW
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State | OH
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Zip | 44224-2755
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Country | US
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Telephone | 330-472-0372
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Fax | 330-649-2713
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN JOSEPH GALLAGHER
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Credential | DPT
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Telephone | 330-472-0372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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