Provider Demographics
NPI:1962638304
Name:GALLAGHER CHIROPRACTIC CLINIC LLC
Entity Type:Organization
Organization Name:GALLAGHER CHIROPRACTIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-224-6426
Mailing Address - Street 1:9607 NEW SAPULPA RD
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-8273
Mailing Address - Country:US
Mailing Address - Phone:918-224-6426
Mailing Address - Fax:918-224-6482
Practice Address - Street 1:9607 NEW SAPULPA RD
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-8273
Practice Address - Country:US
Practice Address - Phone:918-224-6426
Practice Address - Fax:918-224-6482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty