Individual
MS. CLAIRE LYN BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LD CDE
Contact information
Practice address
516 EAST NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1496
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1496
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD519
OK
Other
Enumeration date
03/08/2007
Last updated
04/24/2014
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