TINA J SOUTHWARD

ROSWELL, NM
NPI1164434387
Former NameTINA J WILCOX
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: NM  95-PA10)
Enumeration Date2006-08-13
Last Update Date2019-07-12
Business Address
TINA J SOUTHWARD PAC
75 UNIVERISTY BLVD STE 130
ROSWELL, NM 88203
Phone number: 575-624-7207
Mailing Address
TINA J SOUTHWARD PAC
PO BOX 1574
ROSWELL, NM 88202-1574
Phone number: 575-624-3470
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