Provider Demographics
NPI:1346486313
Name:DAYTON, LISA GALLAGHER (DC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:GALLAGHER
Last Name:DAYTON
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 1:518A CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3809
Mailing Address - Country:US
Mailing Address - Phone:707-433-4248
Mailing Address - Fax:
Practice Address - Street 1:518A CENTER ST
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3809
Practice Address - Country:US
Practice Address - Phone:707-433-4248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor