Individual
MR. GREG ALLEN KIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1901 REDROCK DR, GALLUP, NM 87301-5683
(505) 863-7136
Mailing address
3303 CHURCH ROCK ST, GALLUP, NM 87301-4505
(505) 863-6464
(505) 726-6719
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2734
NM
Other
Enumeration date
11/21/2008
Last updated
11/21/2008
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