| NPI | 1922273697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK PENDRY Manager 505-991-6961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |