| NPI | 1649288713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBI HARRIS Practice Administrator 505-507-2509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 364SM0705X Clinical Nurse Specialist, Medical-Surgical | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2016-11-14 |