Provider Demographics
NPI:1184039844
Name:GALLOWAY, BRIANNE RENE (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIANNE
Middle Name:RENE
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W 1ST AVE
Mailing Address - Street 2:STE. 202
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3461
Mailing Address - Country:US
Mailing Address - Phone:614-632-6526
Mailing Address - Fax:
Practice Address - Street 1:3600B OLENTANGY RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3441
Practice Address - Country:US
Practice Address - Phone:614-451-7244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-21
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6273T3189152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist