| NPI | 1619040268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL S FULLERTON President 505-955-8420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NM 3233) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2008-06-02 |