Individual
LANE GUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 MOONGLOW AVE, ALAMOGORDO, NM 88310-3339
(575) 434-4510
Mailing address
5000 BIRCH ST, 3000 WEST TOWER, NEWPORT BEACH, CA 92660-2127
(888) 835-0894
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6695122-2402
UT
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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