Provider Demographics
NPI:1770601981
Name:GALLAGHER, SEAN SIMON (DC)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:SIMON
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 1:143 PALMER AVE
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2871
Mailing Address - Country:US
Mailing Address - Phone:508-457-6000
Mailing Address - Fax:508-457-7150
Practice Address - Street 1:143 PALMER AVE
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2871
Practice Address - Country:US
Practice Address - Phone:508-457-6000
Practice Address - Fax:508-457-7150
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1847111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36327Medicare ID - Type Unspecified
MAY36327Medicare PIN