| NPI | 1649579780 |
|---|---|
| Doing Business As | JOHN BRYAN STUPPY |
| Entity Type | Organization |
| Authorized Contact | JOHN BRYAN STUPPY Clinical Social Worke 505-930-4550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NM I-06160) |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2011-03-15 |