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Individual

GAVIN GIGSTAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2150 SILVER CREEK RD, BULLHEAD CITY, AZ 86442-8472
(928) 763-8700
Mailing address
547 E SAVANNAH ST, VAIL, AZ 85641-2342

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5226
AZ

Other

Enumeration date
04/29/2013
Last updated
04/29/2013
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