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1043609753
LOWELL MONTANA BENCOMO
LAS CRUCES, NM
NPI
1043609753
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: NM 697)
Enumeration Date
2015-01-19
Last Update Date
2017-03-06
Business Address
MR. LOWELL MONTANA BENCOMO ATC
2404 S LOCUST ST STE 5
LAS CRUCES, NM 88001-5789
Phone number: 575-521-4188
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Mailing Address
MR. LOWELL MONTANA BENCOMO ATC
2404 S LOCUST ST STE 5
LAS CRUCES, NM 88001-5789
Phone number: 575-521-4188
Copy
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