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 |