Individual
MRS. LIBERTY JAVENIA ANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1839
Mailing address
1905 MERRITT, GALLUP, NM 87301-4808
(505) 409-8290
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3162
NM
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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