LEVI COLTER BLACK

ROSWELL, NM
NPI1508185760
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: AZ  CRNA0680)
Enumeration Date2010-05-26
Last Update Date2021-07-05
Business Address
LEVI COLTER BLACK CRNA
117 E 19TH ST
ROSWELL, NM 88201-5151
Phone number: 814-877-2137
Mailing Address
LEVI COLTER BLACK CRNA
530B HARKLE RD STE 100
SANTA FE, NM 87505-4739
Phone number: 480-254-1430
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