Individual
TRACEY GALLAGHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
B2668
CO
208VP0000X
Pain Medicine Physician
B2668
CO
Other
Enumeration date
06/02/2015
Last updated
06/02/2015
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