Provider Demographics
NPI:1750466306
Name:GALLIGAN, GAIL SHANNON (DC)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:SHANNON
Last Name:GALLIGAN
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 1:1221 FLORAL PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6238
Mailing Address - Country:US
Mailing Address - Phone:910-790-4575
Mailing Address - Fax:910-790-7819
Practice Address - Street 1:1221 FLORAL PARKWAY
Practice Address - Street 2:SUITE 103
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6238
Practice Address - Country:US
Practice Address - Phone:910-790-4575
Practice Address - Fax:910-790-7819
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0845KOtherBCBS
NC2453965OtherCIGNA
NC890845KMedicaid
NC2453965OtherCIGNA
NC890845KMedicaid