| NPI | 1922325067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA MITCHELL Administrator 505-287-2950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM MD2009-0779) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2010-04-29 |