| NPI | 1750702437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN FAWN LOVE Physician 575-740-0427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM 20050468) |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2014-05-22 |