AMANDA BUSTAMANTE PROVENCIO

LAS CRUCES, NM
NPI1558855650
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: NM  RS2018-0570)
Enumeration Date2018-06-21
Last Update Date2025-08-25
Business Address
Dr. AMANDA BUSTAMANTE PROVENCIO MD
1240 S TELSHOR BLVD STE A
LAS CRUCES, NM 88011-4731
Phone number: 575-259-3638
Mailing Address
Dr. AMANDA BUSTAMANTE PROVENCIO MD
1240 S TELSHOR BLVD STE A
LAS CRUCES, NM 88011-4731
Phone number: 575-259-3638