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1598186538
DAN VANDERIET
GALLUP, NM
NPI
1598186538
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MI 4301051395)
Enumeration Date
2013-12-17
Last Update Date
2013-12-17
Business Address
DAN VANDERIET M.D.
2401 MARIYANA ST
GALLUP, NM 87301-5635
Phone number: 505-726-8360
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Mailing Address
DAN VANDERIET M.D.
2401 MARIYANA ST
GALLUP, NM 87301-5635
Phone number: 505-726-8360
Copy
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