Regina Gantt, CSFA
NPI #1396121505 in Peralta, New Mexico
Provider Information
- NPI Number
- 1396121505
- Entity Type
- Individual
- Name
- Regina Gantt, CSFA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant - Surgical
- Credential
- CSFA
- Enumeration Date
- Aug 11, 2015
- Last Updated
- Jan 13, 2016
Practice Location
- Address
- 28 VALLE LINDO ROAD
- City
- Peralta
- State
- New Mexico
- ZIP Code
- 87042
- Phone
- (505) 280-5326
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Surgical — Surgical |
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