| NPI | 1093186694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WILLIAM BRADLEY Director Of Operations 575-693-3171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2015-10-08 |