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1558855650
AMANDA BUSTAMANTE PROVENCIO
LAS CRUCES, NM
NPI
1558855650
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NM RS2018-0570)
Enumeration Date
2018-06-21
Last Update Date
2018-06-21
Business Address
Dr. AMANDA BUSTAMANTE PROVENCIO MD
2450 S TELSHOR BLVD
LAS CRUCES, NM 88011-5141
Phone number: 575-521-5385
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Mailing Address
Dr. AMANDA BUSTAMANTE PROVENCIO MD
2450 S TELSHOR BLVD
LAS CRUCES, NM 88011-5141
Phone number:
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