| NPI | 1053316208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M STANLEY Owner 505-388-5170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM A-1194-02) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2008-05-12 |