| NPI | 1932206117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK UNVERZAGT President 505-246-1670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NM 03-061797-00-9) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-04-29 |