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1962767335
DAVID GERALD DEISSENBERG
LAS CRUCES, NM
NPI
1962767335
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: NM 6557)
Enumeration Date
2012-07-11
Last Update Date
2012-07-11
Business Address
Mr. DAVID GERALD DEISSENBERG
126 S DOWNTOWN MALL
LAS CRUCES, NM 88001-1218
Phone number: 702-596-2514
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Mailing Address
Mr. DAVID GERALD DEISSENBERG
5010 DUNN DR
LAS CRUCES, NM 88011-8803
Phone number: 702-596-2514
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