Provider Demographics
NPI:1316028426
Name:GALLO, CHRISTOPHER J (MSPT,CSCS)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:J
Last Name:GALLO
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Gender:M
Credentials:MSPT,CSCS
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Mailing Address - Street 1:1601 ZINFANDEL DR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-7415
Mailing Address - Country:US
Mailing Address - Phone:707-778-1808
Mailing Address - Fax:707-778-1808
Practice Address - Street 1:1211 N DUTTON AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-4660
Practice Address - Country:US
Practice Address - Phone:707-579-1411
Practice Address - Fax:707-579-3044
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT13642225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist