| NPI | 1750717575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LOU SINGLETON Owner 505-573-5134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NM CNP 02228) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |