| NPI | 1205205630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALWYN KOIL Owner 505-463-6618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM 2003-0567) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2018-05-15 |