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1053805671
JEREMY GANZ
CLOVIS, NM
NPI
1053805671
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Additional Taxonomies
171000000X Military Health Care Provider
Enumeration Date
2018-06-18
Last Update Date
2024-01-22
Business Address
JEREMY GANZ PA
27TH SPECIAL OPERATIONS MEDICAL GROUP 224 W D. L. INGRAM AVENUE, BLDG. 1408
CLOVIS, NM 88103
Phone number: 314-226-8463
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Mailing Address
JEREMY GANZ PA
27TH SPECIAL OPERATIONS MEDICAL GROUP 224 W D. L. INGRAM AVENUE, BLDG. 1408
CANNON AFB, NM 88103
Phone number:
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