Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 3379 | OH |
NPI | 1245264712 |
---|---|
Provider Name | Dr. Kelly A Gallagher |
First Address | Cuyahoga Falls, OH 44221-2359 |
Second Address | Cuyahoga Falls, OH 44221-3055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 08/07/2007 |