Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GREGORY BUNDRICK, LISW
Active Sole ProprietorGREGORY BUNDRICK, LISW is a Social Worker healthcare provider located in ESAPNOLA, New Mexico. NPI 1871758755 is currently active in the NPPES registry. Verify at CMS.
Social Worker · ESAPNOLA, NM
Registration Details
- NPI Number
- 1871758755
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 21, 2008 (17.879941561745 yrs)
- Last Updated
- Jul 21, 2008
- License
-
I06545 (NM)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1206 NORTH RIVERSIDE DRIVEAYUDANTESESAPNOLA, NM, 87532Browse NM providers · Browse ZIP 87532
- Phone
- 5057470102
- Primary Specialty
-
Social Worker
104100000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.