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1578135521
ALEXANDER THOMAS VINING
ESPANOLA, NM
NPI
1578135521
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NM PA2021-0060)
Enumeration Date
2021-07-10
Last Update Date
2024-02-08
Business Address
ALEXANDER THOMAS VINING PA-C
1010 SPRUCE ST ENERGENCY MEDICINE - ESPANOLA
ESPANOLA, NM 87532-2746
Phone number: 505-753-7111
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Mailing Address
ALEXANDER THOMAS VINING PA-C
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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