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1508151978
STACEY DIMITT
GRANTS, NM
NPI
1508151978
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: KS 7613)
Enumeration Date
2011-06-14
Last Update Date
2020-09-02
Business Address
STACEY DIMITT MD
1423 E ROOSEVELT AVE
GRANTS, NM 87020-2245
Phone number: 505-287-6500
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Mailing Address
STACEY DIMITT MD
1423 E ROOSEVELT AVE
GRANTS, NM 87020-2245
Phone number: 505-287-6500
Copy
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