Individual
SEAN MARSHALL GALLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
(805) 781-4275
Mailing address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
(805) 781-4275
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 40085
CA
Other
Enumeration date
08/03/2016
Last updated
09/07/2020
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