NPI | 1467691022 |
---|---|
Entity Type | Organization |
Authorized Contact | GLENN MICHAEL DEMPSEY President 505-848-3773 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NM 69-126) |
Enumeration Date | 2009-02-05 |
Last Update Date | 2009-02-05 |