JOHNNY BACA

PORTALES, NM
NPI1760788939
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2011-02-04
Last Update Date2011-02-04
Business Address
-- JOHNNY BACA
220 W 2ND ST
PORTALES, NM 88130-6232
Phone number: 575-356-2222
Mailing Address
-- JOHNNY BACA
PO BOX 28220
SANTA FE, NM 87592-8220
Phone number: 505-471-5006
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