NPI | 1063809085 |
---|---|
Other Name | N/A |
Entity Type | Organization |
Authorized Contact | ANTHONY T SEDILLO Owner 505-261-7380 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NM 2270) |
Enumeration Date | 2015-04-16 |
Last Update Date | 2015-04-16 |