Individual
MR. TROY GUSTAVESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5910 N LA CHOLLA BLVD, TUCSON, AZ 85741-3535
(520) 297-0404
(520) 297-0436
Mailing address
5910 N LA CHOLLA BLVD, TUCSON, AZ 85741-3535
(520) 297-0404
(520) 297-0436
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6477
AZ
Other
Enumeration date
10/21/2016
Last updated
01/07/2017
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