Provider Demographics
NPI:1730198680
Name:COONEY, GALE F (DC)
Entity type:Individual
Prefix:
First Name:GALE
Middle Name:F
Last Name:COONEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32402-0007
Mailing Address - Country:US
Mailing Address - Phone:850-785-9180
Mailing Address - Fax:850-785-9322
Practice Address - Street 1:2410 LISENBY AVENUE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405
Practice Address - Country:US
Practice Address - Phone:850-785-9180
Practice Address - Fax:850-785-9322
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381034800Medicaid
FLP00098307OtherRAILROAD MEDICAIRE
FLP00098307OtherRAILROAD MEDICAIRE
FL381034800Medicaid