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1083277545
GABRIEL GONZALES-WICKETTS
ALBUQUERQUE, NM
NPI
1083277545
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: NM PTA1588)
Enumeration Date
2019-04-19
Last Update Date
2019-04-19
Business Address
GABRIEL GONZALES-WICKETTS
2929 COORS BLVD NW
ALBUQUERQUE, NM 87120-1173
Phone number: 505-836-4899
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Mailing Address
GABRIEL GONZALES-WICKETTS
3844 HAVASU FALLS ST NE
RIO RANCHO, NM 87144-2545
Phone number: 505-259-9732
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