Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 00991 | MO |
NPI | 1003071382 |
---|---|
Provider Name | Ms. Sharon S Gallagher |
First Address | Florissant, MO 63031 |
Second Address | Florissant, MO 63031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2008 |
Last Update Date | 28/07/2008 |