Individual
MIRIAM GALLIFANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
25555 W DURANGO ST, BUCKEYE, AZ 85326-9176
(623) 925-3400
Mailing address
25555 W DURANGO ST, BUCKEYE, AZ 85326-9176
(623) 925-3400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5095
AZ
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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