| NPI | 1356405369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER K TIERNAN President 505-821-1146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM 03079971006) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2010-08-21 |