BENNIE SHEPHERD

PORTALES, NM
NPI1407118706
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2012-06-12
Last Update Date2012-06-12
Business Address
-- BENNIE SHEPHERD
1111 W FIR ST
PORTALES, NM 88130-5826
Phone number: 575-356-5112
Mailing Address
-- BENNIE SHEPHERD
PO BOX 28220
SANTA FE, NM 87592-8220
Phone number:
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