Provider Demographics
NPI:1417178245
Name:GALLANT, JOHN (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:GALLANT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 ROBBINS RD # 2
Mailing Address - Street 2:
Mailing Address - City:RINDGE
Mailing Address - State:NH
Mailing Address - Zip Code:03461-5470
Mailing Address - Country:US
Mailing Address - Phone:978-243-7402
Mailing Address - Fax:
Practice Address - Street 1:1102 ROUTE 119
Practice Address - Street 2:
Practice Address - City:RINDGE
Practice Address - State:NH
Practice Address - Zip Code:03909-1629
Practice Address - Country:US
Practice Address - Phone:603-899-5153
Practice Address - Fax:603-899-5173
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1071111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM7600Medicare ID - Type Unspecified
MEU73609Medicare UPIN