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Individual

MYRNA PHYLLIS GORMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
HWY 160 MP 394.3, KAYENTA, AZ 86033
(928) 697-4000
Mailing address
PO BOX 3412, KAYENTA, AZ 86033-3412
(928) 697-4000

Taxonomy

Speciality
Code
Description
License number
State
374700000X
Technician
Primary

Other

Enumeration date
12/02/2025
Last updated
12/04/2025
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