ENTEGRATIVE OTOLARYNGOLOGY PC
Medical Practice at Sonoma Ave, Santa Rosa, CA

License number
California C3527438
Category
Medical Practice
Type
Otolaryngology/Facial Plastic Surgery
Owner
Name: LARRY KYLE GAMBRELL D.O.
Title: DIRECTOR/CEO
Phone: (267) 456-4848
Address
Address
1144 Sonoma Ave STE 101, Santa Rosa, CA 95405
National Provider ID: 1417294174
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Entegrative Otolaryngology PC

Santa Rosa, CA  -  Sebastopol, CA

Registration:
Jan 7, 2013
Addresses:
1144 Sonoma Ave, Santa Rosa, CA 95405
6880 Palm Ave, Sebastopol, CA 95472
State ID:
03527438
Business type:
Articles of Incorporation
President:
Larry Kyle Gambrell (President)

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