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NPI Code Detail

MEDICARE: DR TIMOTHY W GALLAGHER DC PC

MEDICARE: DR TIMOTHY W GALLAGHER DC PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist
2111N00000XChiropractor2172MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y39984OTHERMABLUE SHIELD

General Provider Information

NPI Number : 1265572671
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR TIMOTHY W GALLAGHER DC PC
Provider Business Mailing Address
First Line : 54 WILLIAMS ST
Second Line :
City : LEOMINSTER
State : MA
Zip : 01453-3276
Country : US
Telephone Number : 978-537-0555
Fax Number : 978-537-2193
Provider Business Practice Location Address
First Line : 54 WILLIAMS ST
Second Line :
City : LEOMINSTER
State : MA
Zip : 01453-3276
Country : US
Telephone Number : 978-537-0555
Fax Number : 978-537-2193
Authorized Official
Title or Position : OWNER
Name : DR. TIMOTHY GALLAGHER
Credential : DC
Telephone Number : 978-537-0555
Provider Enumeration Date : 02/07/2007
Last Update Date : 11/21/2014

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