Individual
MARVIN GANDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
CORNER ROUTE 7 AND ROUTE 12, FORT DEFIANCE, AZ 86504
(928) 729-8600
Mailing address
811 S SIXTH ST, GALLUP, NM 87301-5833
(505) 457-6780
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN210417
AZ
Other
Enumeration date
11/25/2022
Last updated
11/25/2022
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