Individual
LAURIE GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2195 IRONWOOD CT, COEUR D ALENE, ID 83814-2628
(208) 769-1406
(208) 769-1430
Mailing address
2195 IRONWOOD CT, COEUR D ALENE, ID 83814-2628
(208) 769-1406
(208) 769-1430
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA744
ID
Other
Enumeration date
10/20/2005
Last updated
06/27/2014
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