Individual
GARY RUSSELL STANDIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1667 LUCERNE ST, SUITE B, MINDEN, NV 89423-4372
(775) 783-7606
(775) 783-7605
Mailing address
1667 LUCERNE ST, SUITE B, MINDEN, NV 89423-4372
(775) 783-7606
(775) 783-7605
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1503
NV
Other
Enumeration date
02/14/2012
Last updated
02/14/2012
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