Individual
TRINITY VALLEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
311 E SPRUCE ST, GARDEN CITY, KS 67846-5614
(620) 275-3710
(620) 271-3133
Mailing address
395 W 12TH AVE, THIRD FLOOR, COLUMBUS, OH 43210-1267
(614) 293-3989
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-43172
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2017
Last updated
11/24/2020
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