| NPI | 1962415364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN H MOEZZI President 575-443-0339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NM 95-302) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2010-02-21 |