NPI | 1962415364 |
---|---|
Doing Business As | INDIAN WELLS FAMILY PRACTICE |
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 |