Provider Demographics
NPI:1073740171
Name:GALLY, TODD (MPT)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:GALLY
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 QUEENSBERRY CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3334
Mailing Address - Country:US
Mailing Address - Phone:412-427-5443
Mailing Address - Fax:
Practice Address - Street 1:224 QUEENSBERRY CT
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3334
Practice Address - Country:US
Practice Address - Phone:412-427-5443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013297L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist