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Individual

ANN GALLOWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2080 S E ST, SAN BERNARDINO, CA 92408-2773
(909) 388-9191
Mailing address
2080 S E ST, SAN BERNARDINO, CA 92408-2773

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95025711
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1124100383
CA
Enumeration date
09/30/2014
Last updated
09/30/2014
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