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1124709217
KEVIN R BLAIN
SANTA TERESA, NM
NPI
1124709217
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2023-07-31
Last Update Date
2023-08-01
Business Address
KEVIN R BLAIN
5312 RIO BRAVO DR STE 10
SANTA TERESA, NM 88008-9210
Phone number: 575-915-1338
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Mailing Address
KEVIN R BLAIN
PO BOX 2523
SUNLAND PARK, NM 88063-2523
Phone number: 575-915-1338
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