Individual
MICHAEL ANDREW GANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSW
Contact information
Practice address
303 N ALAMEDA BLVD, LAS CRUCES, NM 88005-2590
(575) 523-0111
(575) 323-3046
Mailing address
303 N ALAMEDA BLVD, LAS CRUCES, NM 88005-2590
(575) 523-0111
(575) 323-3046
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1598
NM
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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