| NPI | 1780873547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT PENNINGTON Physician Owner 505-625-5512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NM 95321) |
| Additional Taxonomies | 208VP0000X (Licence: NM 95321) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-10-17 |