Provider Demographics
NPI:1508049164
Name:GALLO CHIROPRACTIC OFFICE INC
Entity Type:Organization
Organization Name:GALLO CHIROPRACTIC OFFICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:G
Authorized Official - Last Name:GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-792-4357
Mailing Address - Street 1:7018 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2508
Mailing Address - Country:US
Mailing Address - Phone:941-792-4357
Mailing Address - Fax:941-792-4341
Practice Address - Street 1:7018 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2508
Practice Address - Country:US
Practice Address - Phone:941-792-4357
Practice Address - Fax:941-792-4341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty