Provider Demographics
NPI:1598996977
Name:GALLAGHER, SEAN M (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:M
Last Name:GALLAGHER
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 1:3646 FORBES TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1054
Mailing Address - Country:US
Mailing Address - Phone:724-875-2657
Mailing Address - Fax:
Practice Address - Street 1:3253 OLD FRANKSTOWN RD
Practice Address - Street 2:SUITE H
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-2940
Practice Address - Country:US
Practice Address - Phone:724-875-2657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007226111N00000X
PADC010651111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0204583Medicaid
IA223920006Medicare PIN
IA426081293OtherBCBS