Individual
DR. SHANE GALLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4753 COUNTY HIGHWAY J, LAKE HALLIE, WI 54729-3387
(720) 448-5274
Mailing address
4753 COUNTY HIGHWAY J, LAKE HALLIE, WI 54729-3387
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5073
WI
Other
Enumeration date
05/31/2017
Last updated
05/31/2017
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