| NPI | 1770724916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHARLES LEECH Owner 505-888-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: NM A 830 86) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2014-11-13 |