Provider Demographics
NPI:1538220728
Name:GALLAGHER CHIROPRACTIC, P.A.
Entity type:Organization
Organization Name:GALLAGHER CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-542-6500
Mailing Address - Street 1:7810 BALLANTYNE COMMONS PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3415
Mailing Address - Country:US
Mailing Address - Phone:704-542-6500
Mailing Address - Fax:704-542-7476
Practice Address - Street 1:7810 BALLANTYNE COMMONS PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3415
Practice Address - Country:US
Practice Address - Phone:704-542-6500
Practice Address - Fax:704-542-7476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2454073Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER