ETHAN A PRAIRIE

RIO RANCHO, NM
NPI1134749195
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: NM  MD2023-0538)
Enumeration Date2020-04-20
Last Update Date2023-12-29
Business Address
ETHAN A PRAIRIE MD
4005 HIGH RESORT BLVD SE
RIO RANCHO, NM 87124-5906
Phone number: 505-462-6000
Mailing Address
ETHAN A PRAIRIE MD
4005 HIGH RESORT BLVD SE
RIO RANCHO, NM 87124-5906
Phone number: 505-462-6000
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