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Individual

GERERON JERALD DAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MT

Contact information

Practice address
394.3 HIGHWAY 160, KAYENTA, AZ 86033
(928) 697-4140
(928) 697-4142
Mailing address
PO BOX 368, KAYENTA, AZ 86033-0368
(928) 697-4140

Taxonomy

Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
213216

Other

Enumeration date
12/14/2017
Last updated
12/14/2017
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