Individual
MR. STUART GALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CRNA
Contact information
Practice address
135 S GIBSON ST, MEDFORD, WI 54451-1622
(715) 748-8100
(715) 748-8847
Mailing address
W5707 JOLLY AVE, MEDFORD, WI 54451-9302
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44311500
—
WI
Enumeration date
07/12/2006
Last updated
07/08/2007
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