| NPI | 1619113032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN R. VIGIL CEO/Medical Director 505-452-9015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NM 89-319) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |