Individual
MARTHA TRUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
516 E. NIZHONI BLVD., GALLUP, NM 87301
(505) 722-1000
(505) 722-1705
Mailing address
1756 PARK AVE, RIVERTON, UT 84065-4701
(801) 254-0309
(801) 254-1012
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104839-1206
UT
Other
Enumeration date
10/06/2005
Last updated
11/07/2012
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