| NPI | 1962876581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA PEIPER Operations Director 505-377-5733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: NM FA0102165) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |