Individual
OLIN VERNON GUSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
HIGHWAY 86 & TOPAWA RD, SELLS, AZ 85746
(520) 383-7200
Mailing address
14355 S CAMINO VALLADO, SAHUARITA, AZ 85629-8437
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
RN183767
AZ
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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