SHANE PARKS

GALLUP, NM
NPI1588988745
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: OH  COA.11341-NA)
Enumeration Date2010-03-17
Last Update Date2010-03-17
Business Address
-- SHANE PARKS CRNA
516 E NIZHONI BLVD
GALLUP, NM 87301
Phone number: 505-722-1000
Mailing Address
-- SHANE PARKS CRNA
PO BOX 1337
GALLUP, NM 87305-1337
Phone number: 505-722-1000
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