Provider Demographics
NPI:1447356225
Name:GALT, JEFFREY R (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:R
Last Name:GALT
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 1:615 MAIN ST
Mailing Address - Street 2:P.O. BOX 338
Mailing Address - City:CARRINGTON
Mailing Address - State:ND
Mailing Address - Zip Code:58421-1661
Mailing Address - Country:US
Mailing Address - Phone:701-652-2631
Mailing Address - Fax:
Practice Address - Street 1:615 MAIN ST
Practice Address - Street 2:
Practice Address - City:CARRINGTON
Practice Address - State:ND
Practice Address - Zip Code:58421-1661
Practice Address - Country:US
Practice Address - Phone:701-652-2631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND015656Medicaid
ND4340OtherBC/BS OF ND
NDN4340Medicare ID - Type Unspecified
ND015656Medicaid