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Individual

JOHN R GALLAHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
401 W MAIN ST STE 101, LEBANON, TN 37087-3555
(615) 444-9111
(615) 444-1040
Mailing address
401 W MAIN ST, STE 102, LEBANON, TN 37087-3584
(615) 444-9111
(615) 444-1040

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT1493
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
261354605
DEFAULT
TN
05
3599128
TN
01
4165732
BCBS
TN
Enumeration date
08/01/2005
Last updated
11/20/2018
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