Provider Demographics
NPI:1235123035
Name:GALLOUP, FINTON FRANCOIS (DC)
Entity type:Individual
Prefix:DR
First Name:FINTON
Middle Name:FRANCOIS
Last Name:GALLOUP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 KIRKLAND COURT
Mailing Address - Street 2:PO BOX 309
Mailing Address - City:ACME
Mailing Address - State:MI
Mailing Address - Zip Code:49610
Mailing Address - Country:US
Mailing Address - Phone:231-938-2240
Mailing Address - Fax:
Practice Address - Street 1:3502 KIRKLAND COURT
Practice Address - Street 2:
Practice Address - City:ACME
Practice Address - State:MI
Practice Address - Zip Code:49610
Practice Address - Country:US
Practice Address - Phone:231-938-2240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2122737Medicaid
MIT32823Medicare UPIN
MI2122737Medicaid