| NPI | 1285958199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN BENTZ Co Manager 505-818-8588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NM R17548) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2010-03-22 |