| NPI | 1750598686 |
|---|---|
| Former Legal Business Name | SAME AS ABOVE |
| Entity Type | Organization |
| Authorized Contact | ROBERT C JONES Owner 505-256-3648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |