Individual
MAYA ROSE BERNADETT-PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301
(505) 722-1000
Mailing address
PO BOX 1337, GALLUP, NM 87301
(505) 722-1000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4873
NM
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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