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Individual

TAMMY LYNN GILMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10770 HOLE AVENUE, 106, RIVERSIDE, CA 92505
(951) 807-1265
Mailing address
10770 HOLE AVENUE, 106, RIVERSIDE, CA 92505
(951) 807-1265

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
BL00128774
CA

Other

Enumeration date
12/29/2011
Last updated
12/29/2011
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