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Individual

JAMES GABRIEL GAYTAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
875 PERIMETER DR, MOSCOW, ID 83844-9803
(208) 885-6111
Mailing address
1024 WINTER ST, KINGSBURG, CA 93631-1034
(559) 419-3334

Taxonomy

Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
ID
390200000X
Student in an Organized Health Care Education/Training Program
Primary
ID

Other

Enumeration date
05/19/2023
Last updated
05/19/2023
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