| NPI | 1669540076 |
|---|---|
| Doing Business As | GALLUP TEEN HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | DOUG SMITH Executive Vice President 505-982-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health (Licence: NM 6437) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2021-01-09 |