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1568762805
JACK ANTHONY AYALA
ALBUQUERQUE, NM
NPI
1568762805
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2010-11-02
Last Update Date
2010-11-02
Business Address
Mr. JACK ANTHONY AYALA
1225 4TH ST NW
ALBUQUERQUE, NM 87102-1414
Phone number: 505-212-7363
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Mailing Address
Mr. JACK ANTHONY AYALA
1225 4TH ST NW
ALBUQUERQUE, NM 87102-1414
Phone number: 505-212-7363
Copy
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