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1346798204
MATHEW THERON SOUTHWICK
FARMINGTON, NM
NPI
1346798204
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Additional Taxonomies
363AS0400X Physician Assistant, Surgical
Enumeration Date
2016-09-20
Last Update Date
2016-09-20
Business Address
-- MATHEW THERON SOUTHWICK P.A.-C.
2300 E 30TH ST BLDG D-101
FARMINGTON, NM 87401-8991
Phone number: 505-327-1400
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Mailing Address
-- MATHEW THERON SOUTHWICK P.A.-C.
2300 E 30TH ST BLDG D-101
FARMINGTON, NM 87401-8991
Phone number: 505-327-1400
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