Provider Demographics
NPI:1366527244
Name:GALLAGHER, PATTRICK SCOTT (DC)
Entity type:Individual
Prefix:
First Name:PATTRICK
Middle Name:SCOTT
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 1:1011 W WILLIAMS ST STE 104
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3979
Mailing Address - Country:US
Mailing Address - Phone:919-303-2213
Mailing Address - Fax:919-303-0332
Practice Address - Street 1:1304 E ASH ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-5106
Practice Address - Country:US
Practice Address - Phone:919-735-4300
Practice Address - Fax:919-735-2424
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2348739Medicare ID - Type Unspecified
NCU85729Medicare UPIN