Individual
JUSTIN G GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
404 S BRADLEY ST, WARREN, AR 71671-3459
(870) 226-3731
(952) 442-3620
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C02886
AR
Other
Enumeration date
10/28/2011
Last updated
11/08/2011
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