MEDICARE: KEVIN M. GALLAGHER D.C. P.A.

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
1	111N00000X	Chiropractor	CH6550	FL

General Provider Information

NPI Number	:	1518238575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEVIN M. GALLAGHER D.C. P.A.

Provider Business Mailing Address
First Line	:	550 ALT 19
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-4431
Country	:	US
Telephone Number	:	727-789-0800
Fax Number	:	727-787-0862

Provider Business Practice Location Address
First Line	:	550 ALT 19
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-4431
Country	:	US
Telephone Number	:	727-789-0800
Fax Number	:	727-787-0862

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KEVIN M. GALLAGHER
Credential	:	D.C.
Telephone Number	:	727-789-0800

Provider Enumeration Date	:	01/23/2012
Last Update Date	:	01/23/2012

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