| NPI | 1891499299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME JEREMY CORDOVA Owner 505-480-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-03-29 |