BRIAN R INGRAM

EDGEWOOD, NM
NPI1700368495
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NM  PA2018-0050)
Enumeration Date2018-08-30
Last Update Date2018-08-30
Business Address
BRIAN R INGRAM PA
1851 OLD HWY 66
EDGEWOOD, NM 87015
Phone number: 505-286-2396
Mailing Address
BRIAN R INGRAM PA
12127B HWY 14 N STE 5
CEDAR CREST, NM 87008-9499
Phone number: 505-281-5180
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