Provider Demographics
NPI:1417365792
Name:GALLOWAY CHIROPRACTIC PASCO
Entity type:Organization
Organization Name:GALLOWAY CHIROPRACTIC PASCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-937-9726
Mailing Address - Street 1:8142 BELLARUS WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1799
Mailing Address - Country:US
Mailing Address - Phone:727-937-9726
Mailing Address - Fax:727-934-2870
Practice Address - Street 1:8142 BELLARUS WAY STE 102
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1799
Practice Address - Country:US
Practice Address - Phone:727-937-9726
Practice Address - Fax:727-934-2870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9352111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty