Individual
GRETTA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
280 1ST ST, HOLLOMAN AFB, NM 88330-8273
(575) 572-7091
Mailing address
280 1ST ST, HOLLOMAN AFB, NM 88330-8273
(575) 572-7091
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29856
NE
Other
Enumeration date
06/12/2015
Last updated
03/21/2022
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