Individual
WILLIAM ANTHONY BURROLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSW
Contact information
Practice address
2105 HASSLER VALLEY RD, GALLUP, NM 87301
(505) 413-3447
Mailing address
19 BLUEGILL DR, THOREAU, NM 87323-4002
(505) 728-1637
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
890
NM
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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