| NPI | 1083862114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DANIEL BEALE President CEO 575-680-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NM 93208) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |