Individual
MS. JANIE HIESIRMAN-GORAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 W DEUCE OF CLUBS, #200, SHOW LOW, AZ 85901-2705
(928) 339-4842
Mailing address
PO BOX 850, ALPINE, AZ 85920-0850
(928) 339-4842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9852
AZ
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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