| NPI | 1275139958 |
|---|---|
| Doing Business As | PURE LIFE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | LORETTA TORRES Pa/CEO 505-467-8372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2020-12-08 |