MARY LOUISE BODEWES

FARMINGTON, NM
NPI1659476398
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NM  PA2021-0130)
Additional Taxonomies363A00000X Physician Assistant
(Licence: WI  988)
363A00000X Physician Assistant
(Licence: CO  PA.005343)
Enumeration Date2006-09-14
Last Update Date2024-11-08
Business Address
MARY LOUISE BODEWES PAC
630 W MAPLE ST
FARMINGTON, NM 87401-6113
Phone number: 505-609-6349
Mailing Address
MARY LOUISE BODEWES PAC
PO BOX 844088
DALLAS, TX 75284-4088
Phone number: 505-609-2258