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1841862513
KELLYANN GANGAWARE
ALBUQUERQUE, NM
NPI
1841862513
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NM AT826)
Enumeration Date
2021-07-13
Last Update Date
2022-03-27
Business Address
KELLYANN GANGAWARE LAT, ATC
1414 UNIVERSITY BOULEVARD SE
ALBUQUERQUE, NM 87131-0001
Phone number: 973-960-7391
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Mailing Address
KELLYANN GANGAWARE LAT, ATC
1414 UNIVERSITY BOULEVARD SE
ALBUQUERQUE, NM 87131-0001
Phone number: 973-960-7391
Copy
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