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| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | Gibson Lane | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1750024519 | [sources] | |||
| Status | not available | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from Arizona's Medicaid program.
United States · AHCCCS
For experts: raw data explorer
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