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1366040610
LEROY FERNANDEZ
RATON, NM
NPI
1366040610
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2020-10-09
Last Update Date
2020-10-09
Business Address
LEROY FERNANDEZ
411 S 3RD ST
RATON, NM 87740-4005
Phone number: 575-733-0003
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Mailing Address
LEROY FERNANDEZ
PO BOX 94508
ALBUQUERQUE, NM 87199-4508
Phone number: 505-384-7352
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