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4753 County Highway J, Lake Hallie, WI 54729-3387 | |
(720) 448-5274 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 4753 County Highway J, Lake Hallie, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1285162594 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 5073 (Wisconsin) | Primary |
Provider Name | Shane Gallick |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1932637204 PECOS PAC ID: 7618238874 Enrollment ID: I20180302002058 |
Mailing Address | Practice Location Address |
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4753 County Highway J, Lake Hallie, WI 54729-3387 Ph: (720) 448-5274 | 4753 County Highway J, Lake Hallie, WI 54729-3387 Ph: (720) 448-5274 |
Dr. Shane Gallick, DC Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 4753 County Highway J, Lake Hallie, WI 54729 Phone: 720-448-5274 |