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1013593607
AMANDA FAYE BALLARD
GALLUP, NM
NPI
1013593607
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
246ZS0410X Specialist/Technologist, Other, Surgical Technologist
Enumeration Date
2021-03-23
Last Update Date
2021-03-23
Business Address
AMANDA FAYE BALLARD
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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Mailing Address
AMANDA FAYE BALLARD
1004 8TH ST
LAS VEGAS, NM 87701-4216
Phone number:
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