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Organization

DUKE CITY SURGICAL ASSISTING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REGINA K GANTT (PRESIDENT)
(505) 280-5326
Entity
Organization

Contact information

Practice address
28 VALLE LINDO RD, PERALTA, NM 87042-8230
(505) 280-5326
Mailing address
28 VALLE LINDO RD, PERALTA, NM 87042-8230
(505) 280-5326

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
01/05/2016
Last updated
01/13/2016
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