MATHEW THERON SOUTHWICK

FARMINGTON, NM
NPI1346798204
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Additional Taxonomies363AS0400X Physician Assistant, Surgical
Enumeration Date2016-09-20
Last Update Date2016-09-20
Business Address
-- MATHEW THERON SOUTHWICK P.A.-C.
2300 E 30TH ST BLDG D-101
FARMINGTON, NM 87401-8991
Phone number: 505-327-1400
Mailing Address
-- MATHEW THERON SOUTHWICK P.A.-C.
2300 E 30TH ST BLDG D-101
FARMINGTON, NM 87401-8991
Phone number: 505-327-1400