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1104471085
KELLEN J PINO
ALBUQUERQUE, NM
NPI
1104471085
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2083S0010X Preventive Medicine, Sports Medicine
(Licence: NM 424)
Enumeration Date
2019-08-07
Last Update Date
2019-08-07
Business Address
Mr. KELLEN J PINO MS, LAT, ATC, CES
12200 LOMAS BLVD NE
ALBUQUERQUE, NM 87112-5804
Phone number: 505-559-2200
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Mailing Address
Mr. KELLEN J PINO MS, LAT, ATC, CES
4500 SHADOW AVE NW
ALBUQUERQUE, NM 87114-5063
Phone number: 505-681-0748
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