Individual
DR. WILLIAM BRANT HESIDENCE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
511 E NIZHONI BLVD, GALLUP, NM 87301-5757
(505) 722-1000
Mailing address
511 E NIZHONI BLVD, GALLUP, NM 87301-5757
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
257
AL
213E00000X
Podiatrist
PD0103
LA
213E00000X
Podiatrist
Primary
PO2948
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO 2948
FL
Other
Enumeration date
07/18/2005
Last updated
02/16/2023
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