| NPI | 1124503917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BELINDA MARIE MABRY Owner 575-313-9456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-10-07 |