Individual
GARY LEE WITOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14583 HANSEL AVE, TRUCKEE, CA 96161-6362
(530) 387-3775
Mailing address
14583 HANSEL AVE, TRUCKEE, CA 96161-6362
(530) 387-3775
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA19330
CA
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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