Basic Information
Provider Information
NPI: 1285768945
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALLAGHER
FirstName: GAIL
MiddleName: HEATHER
NamePrefix: DR.
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9097 E DESERT COVE DR
Address2: SUITE 110
City: SCOTTSDALE
State: AZ
PostalCode: 852606279
CountryCode: US
TelephoneNumber: 4808372595
FaxNumber: 4808370356
Practice Location
Address1: 16605 E PALISADES BLVD
Address2: SUITE 144
City: FOUNTAIN HILLS
State: AZ
PostalCode: 852683716
CountryCode: US
TelephoneNumber: 4808372595
FaxNumber: 4808372773
Other Information
ProviderEnumerationDate: 03/15/2007
LastUpdateDate: 08/29/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1158570TXN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X6549AZY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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