DWAYNE MACIAS

GALLUP, NM
NPI1871048074
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2251X0800X Physical Therapist, Orthopedic
(Licence: NM  1619)
Enumeration Date2016-08-18
Last Update Date2016-08-18
Business Address
-- DWAYNE MACIAS
510 W MALONEY AVE
GALLUP, NM 87301-5489
Phone number: 505-488-2620
Mailing Address
-- DWAYNE MACIAS
15 APEX DR
HIGHLAND, IL 62249-1282
Phone number: 618-651-0444
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