| NPI | 1033458146 |
|---|---|
| Other Name | EDWARD WADE RICHARDSON SOLE MEMBER |
| Entity Type | Organization |
| Authorized Contact | EDWARD WADE RICHARDSON Sole Owner 575-524-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NM 962) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2013-04-10 |