| NPI | 1457703522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI BOWMAN Pharmacy Resident 505-550-9248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NM RP00008381) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2016-07-12 |