| NPI | 1427336098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD LEE GLENN Owner/Physician 575-623-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NM 1909) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2011-07-29 |