| NPI | 1013086685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY J DEVINE Owner 505-859-0686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM R48132) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |