| NPI | 1639533516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE D GRACE Owner 505-216-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM CNP-02467) |
| Additional Taxonomies | 172P00000X Naprapath |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2016-08-16 |