NPI | 1235429150 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREW DANIEL JOHNSON President/Owner 575-625-2020 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: NM NM0544) |
Enumeration Date | 2011-04-12 |
Last Update Date | 2011-04-12 |