| NPI | 1174622666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M. WILTERDING Owner 505-265-2244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM 2003-0249) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |