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Individual

DR. MATTHEW J GALLAGHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
502 GREENE AVE, GREEN BAY, WI 54301-2820
(920) 884-9308
Mailing address
2317 WOODROW WAY, GREEN BAY, WI 54301-2144
(920) 884-9308

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4055
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38957500
WI
Enumeration date
10/18/2006
Last updated
07/08/2007
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