| NPI | 1639429632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMIE MCCLURE Owner 505-983-1226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NM 955) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2012-09-17 |