Individual
RONALD JOSAFAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R38054
NM
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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