Individual provider · Type 1 NPI
Edward Johan Gomillion, LMT
Specialist · Phoenix, AZ
NPI number
1093930802
Active
Practice location
3227 E Bell Rd, Suite 201
Phoenix, AZ 85032-2700
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | MT04378P (AZ) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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About NPI 1093930802
Edward Johan Gomillion, LMT's National Provider Identifier is 1093930802, issued on Apr 16, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Phoenix, AZ. The record was last updated on Jul 8, 2007.