NPI | 1427210590 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTHONY MASCIOTRA CEO 505-272-8950 |
Organization Subpart ? | No |
Primary Taxonomy | 261QS1000X Clinic/Center Student Health (Licence: NM PA 2004-0048) |
Enumeration Date | 2008-06-30 |
Last Update Date | 2008-06-30 |