| NPI | 1982854857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK E AMMONS Physician Assistant 505-473-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NM PA2008-0043) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2008-09-26 |